Man HIV positive, wife negative for 18 years

By Lydia Namubiru

For 15 years, Tophia Katusiime, 35, had unprotected sex with her HIV positive husband, Saul Kabakira, 50, but she did not get infected.

The couple, who live in Kasankala, Rakai district, have six children, all of whom are negative.

Katusiime and her husband, the longest known ‘discordant’ couple in Uganda and possibly in the world, are overwhelmed with gratitude for what they consider a miracle in their lives.

Discordant couples are couples where one of the two partners is HIV positive while the other is negative.

Katusiime, who married in 1989, did not know that her husband was HIV positive and had developed full blown AIDS until eight years ago.

“He was sickly from the start of our marriage but I always thought it was witchcraft,” she said at her house in Kasankala. “We sold all our property in search of witchdoctors but he did not get any better.”

Kabakira, at the other hand, suspected he had contracted HIV from a girlfriend, who had died in 1982, after a long illness.

“I started getting sick in 1984,” he said. “My first wife left me because of rumours that I was suffering from AIDS.”

He married Katusiime after his first wife left him “because I could not do without a woman”.

His fears were confirmed when he tested HIV positive in 1995. However, he did not disclose his status to his wife, fearing that she, too, might leave him.

He finally told her in 1999, four years after testing and 10 years into their marriage, when they already had five children.

“At first I wanted to leave him,” Katusiime said. “I told him that for all this time he had kept quiet about the disease so that he could infect me.”

But Kabakira, who at the time had been crippled by his illness, desperately begged her to stay.

“I asked my mother and sister to talk to her. She finally told me: I will stay here until I bury you.”

Katusiime, who grew up as an orphan herself, said she decided to stay because she did not want to abandon the children, whose father she believed might die any time.

For two years, she refused to take an HIV test, believing that she was automatically infected.

Whenever she tried to resist having sex with her husband, he countered her with the argument that there was ‘nothing left to protect’.

In 2001, when her husband started getting free ARVs, he persuaded her to take the HIV test, arguing that she too could get treatment if she tested positive.

To her utter surprise, she was negative. “I was so happy. I rejoiced and still rejoice every day,” Katusiime said between giggles.

Again, she considered leaving her husband. “I can no longer stay with this man who has AIDS!” she told the health worker who gave her the results.

The health worker, however, said they could remain married but practice safe sex. After joint counselling, they decided to use a condom each time they had sex.

Somewhere in 2004, they slipped and had unprotected sex. “I was so scared. I knew that this time, I had definitely got the virus,” Katusiime said.

She conceived their sixth child during that incidence. During one of her antenatal visits, the health worker convinced her to take the HIV test again.

She was still negative. So elated was the couple at this second knock by fortune that they have since converted from Islam to Pentecostalism “to thank and praise God for this miracle.”

Kabakira is determined to stick to the condom. “I cannot drop it. I want my wife to live and look after our children.”

To avoid any undue temptation, they have even separated beds. “I always carefully prepare for sex and only go to her when I am sure I have a condom,” he said.


How come sexual partners can be hiv discordant?

By Charles Wendo

Fifty six percent of married HIV positive people in Uganda are in a discordant union, meaning their partner does not have HIV. Out of 4,000 couples tested countrywide, 91% were HIV negative, 5% were discordant and 3% were HIV positive, according to the National HIV Sero-Behavioural Survey released last year.

Countrywide, in three fifths of the discordant couples, the HIV positive partner was the man. In Kampala, however, it is the opposite. Sixty seven per cent of the HIV+ partners among discordant couples in the city were women.

Experts are puzzled about discordant couples. “The truth is that we do not understand the whole picture and that is why people are now doing a lot of research in that area,” says Dr. Edith Nakku, specialist on sexually transmitted infections in Mulago Hospital.

There are, however, several possibilities being discussed by scientists. A research by the Medical Research Council of UK provided preliminary evidence that some individuals in Kampala and Entebbe might be resistant to HIV.

Other researches in Rakai district have found that some individuals have very low concentrations of HIV in their blood, making them less likely to infect their partners. Also, people who do not get sores on their genitals are less likely to infect their partners. And the less often a couple has sex, the lower the risk of transmitting the virus.

Nakku warns that if they continue having unprotected sex then the HIV negative partner might become infected. “They are not immune, so they need to use condoms and minimise sexual contacts,” says Nakku.

The majority of discordant couples do not yet know their status, according to the survey, which also found out that most of the new HIV infections are among married people.

The state minister for Primary Health Care, Dr. Emmanuel Otaala, says couples should take HIV tests together to find out if they are discordant. He says many new infections could be prevented if discordant couples are detected and the HIV negative partner protected through using condoms and reducing the frequency of sex. “Right now we are focusing our attention on discordant couples, knowing that if nothing is done, many of them will turn out to be HIV positive a year or so later” he says. “Knowing that some people are discordant is a big opportunity for us to accelerate HIV prevention by focusing our attention on this area.”

Otaala says people should not apportion blame if they find themselves in a discordant marriage. “Nobody wants to get HIV,” says Otaala. “They need psycho-social support and counselling from their partners. They need words like: ‘This has happened. What you should concentrate on is how to live a productive life’. They also need support when they fall sick.”