adminCatherine Murombedzi
I RECENTLY got an email from a man who is in a discordant union. The man said they have been married for five years. They underwent HIV testing after they got married and his partner tested HIV positive with him testing negative. He said he loves his wife very much and the outcome of the HIV tests put a damper on their marriage. He, however, did not find this to be a reason to go separate ways.
They were counseled and told to use protection. It is now five years of marriage and both parents are now openly demanding a grandchild from the couple. They are asking what is wrong and offer to help if the need be.
“My parents and even my in-laws are now demanding that we give them a grandchild. I am not in a position to tell them that my wife is HIV positive. I can’t risk getting infected all because I want to have a child and please our parents. I do love the idea of having a child, but the risk is just too big to fathom. Can you help as this is getting me crazy,” wrote the man.
Such issues are very sensitive and we find that this man is just one in a thousand facing the same problem. Some people would argue that they should have taken the HIV test before marriage, but remember there is what is called a window period where the virus is not visible even by tests but lies low. So it can be that one takes a test during that time and later when testing HIV positive in marriage point fingers of infidelity to the person sero-positive yet that person was infected but in the window period.
As the position stands now using protection is a sure way of not spreading the virus to the uninfected partner. Secondly, the infected partner has to be on anti-retroviral therapy for her health and to suppress the viral load.
A person on medication and taking it correctly and consistently for even a year suppresses the virus to an undetectable level if the medication is working as expected. Not all ARVs work as expected and in such a case one has to be changed to the suitable medication.
A discordant couple is a pair of sexual partners in which one partner tests HIV positive and the other is HIV negative. This is so since the risk of infection is variable for different people and different sexual encounters. Risk variability can be explained by a number of factors. The number of HIV viral particles in the blood of the infected person, the presence of co-existing sexual infection in either partner or an individual’s susceptibility to HIV infection.
For some couples the discord is not an issue but for others it can result in some tension, questions and even confusion.
When the HIV positive person in such a union is seeking treatment, the HIV negative partner can be overlooked by the health personnel yet they also are vulnerable and need support. As much as the HIV positive partner needs support from their HIV negative spouse so does the other.
Discordant couples are urged to use protection and it is in circumstances that one needs to have a child that one feels at risk.
HIV does not define who you are or what type of a person you are. A healthy relationship as lived by the young couple in the last five years has been possible but now pressure mounts as grandparents demand a grandchild.
The man’s fear is real and he does not want the family to know why they have not had a child. It is not for him to disclose his wife’s status.
Putting yourself in the shoes of the grandparents would you have reacted in the same manner? Can the wife lie that she has a heart problem or any life threatening health issue?
Speaking to a pastor from my church who wanted to remain anonymous, he said the issue was sensitive and not understood.
“Surely children are a blessing and after a year of marriage it is unusual that family and relatives expect that the newly married start a family.
We usually do not give ourselves time to think why a couple has not had children.
It is a gift a blessing and maybe the couple has health related issues or they have decided that the time is not yet ripe to start a family so all that needs to be taken into consideration,” said the pastor.As for the man who sent an email asking what to do, I advised him that he seeks professional counseling. Secondly, if he had the cash he could go the in-vitro semi-nation way or seek advice from health personnel.
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