HIV, with Dr Watiti

May 22, 2011

WHEN HIV comes into a family setting, it can break it up before even killing the family members, if it is not handled well. <br>What you have gone through should be an eye opener for all people who test HIV-negative, but continue having unprotected sex with partners whose HIV status they do not kno

Dear Doctor,
Recently I went for routine counselling and testing and realised my health was not very good. I was shocked to discover I was HIV-positive and yet about one-and-half years ago I tested negative during antenatal care. When I told my husband about the results, he did not seem shocked. I have since found out that he has actually been on ARVs for the last five years and I did not know. He is on drugs called Combivir and Alluvia. I have since done a CD4 count and have been advised to start taking ARVs immediately because my CD4 count is 300 cells/ml and I am three-months pregnant. Please advise, my life is falling apart.
Justine

Dear Justine,
WHEN HIV comes into a family setting, it can break it up before even killing the family members, if it is not handled well.
What you have gone through should be an eye opener for all people who test HIV-negative, but continue having unprotected sex with partners whose HIV status they do not know.

HIV discordance, where one sexual partner is positive while the other is negative, is common and many times due to fear of blame, rejection or domestic violence, people who test HIV-positive do not immediately disclose to their partners. That is why in many HIV and AIDS service centres, antiretroviral therapy is not started until one comes with his or her sexual partner(s).

HIV is a family disease and when treating it, we must care for the whole family. You need to be counselled as a couple so that you can come up with strategies to cope with the prevailing situation.

Spending a lot of time being angry and blaming your husband will not help. You need to start on ARVs soon, especially because on top of needing them (because your CD4 count is low), they will help you reduce the risk of infecting your baby by lowering the viral load or amount of virus in your blood.

The main challenge you have is that you may have been infected with HIV from your husband, which developed resistance to first line drugs since he is on second line ARVs. This means he failed on the first line regimen.

Your doctor needs to know this so that appropriate action such as resistance testing, if possible, is done on you before you start treatment.

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