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HIV discordance- Why you should not blame the other partner

By Vision Reporter

Added 17th May 2009 03:00 AM

MANY times when married couples test for HIV and find themselves discordant (one HIV-positive and the other HIV-negative), the negative partner accuses the other of infidelity.

MANY times when married couples test for HIV and find themselves discordant (one HIV-positive and the other HIV-negative), the negative partner accuses the other of infidelity.

By Anne Abaho

MANY times when married couples test for HIV and find themselves discordant (one HIV-positive and the other HIV-negative), the negative partner accuses the other of infidelity.

That person thinks the partner wanted to spread the virus intentionally and attempt to ‘kill’ them by spreading the virus.

Theopista Nakinsige, a post-test counsellor in Mukono, says this is more common with men. “Men often become violent and sometimes, abandon their wives,” says Nakinsige.

Consequently, this discourages couples from testing together or disclosing their HIV status even when they test alone.
Last year at the AIDS Information Centre, only 23% of the clients tested as couples. In other centres, it was even lower.

“It is difficult to counsel discordant couples,” Nakinsige said. “One couple fought in the counselling room. The man grabbed his wife by the throat, accusing her of wanting to kill him.”

However, according to Dr Patrick Ndase, an HIV preventive researcher, heterosexual HIV transmission takes place under certain conditions.

“These include the amount of virus in the positive person, use of antiretroviral drugs, the presence of sexually transmitted infections, lack of circumcision and tears (scratches) that occur during sex.”

Ndase explains that a person is more likely to infect their partner in the early days of infection when the body has not recognised the HIV presence.

“HIV takes this chance to multiply and in a day, it can make millions of copies of itself. The more virus there is, the more the person is likely to infect someone else,” Ndase says.

Canadian researchers also reported in the Journal of Infectious Diseases that people are most likely to transmit HIV before even many screening tests can detect the virus. And this may explain why the HIV epidemic moves so quickly.

The Canadian researchers found that 49% of new infections were transmitted by people who were in the early stages of infection, before the virus had time to mutate much.

UN-AIDS reports that 75% of the new infections occur in stable relationships and marriage.

Therefore, in circumstances where a person cheats on the partner and acquires HIV, chances are they will infect the partner during this early stage.
After three months, the body recognises the invasion and reacts by producing antibodies to fight HIV.

These reduce the amount of virus in the body but cannot eliminate it. When a person’s immunity is strong, the virus is reduced to an amount too low to infect another sexual partner.

“If a person who is HIV-positive but at a stage where they have put the infection under control (with small amounts of viral copies) marries an HIV-negative partner, chances of surviving the infection are high,” Ndase adds.

“With time, these may test and prove discordant. So infidelity cannot be a logical conclusion.”

Using an HIV-positive test in a discordant situation to conclude that the partner has cheated on you has no scientific basis.

It is, therefore, important to take an HIV test before marriage or unprotected sex and a confirmatory test after three months to ascertain the status of the partner at the beginning of marriage.

With time, the HIV overwhelms the defences and increases in numbers requiring that the person starts taking antiretroviral therapy. This treatment helps bring down the amount of virus, as well as the infectiousness of that person.

Experts advise the HIV positive partner in discordant couples to adhere to treatment, and the couple to always use a condom whenever they have sex.

ART has decreased the potential for transmission of HIV, according to studies presented at the last International AIDS Conference in Mexico.

HIV discordance- Why you should not blame the other partner

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