In a relationship, it is possible for one partner to be HIV-negative and the other HIV-positive. This is known as a sero-discordant couple or a mixed-status couple.
In Zimbabwe, the prevalence of discordant couples is as high as 12% meaning that there are as many as 12 discordant couples per every 100 with one partner who is HIV positive.
It is very important that couples who are in a relationship or a marriage get tested for HIV together.
Testing for HIV together and receiving counselling as partners can make it easier to disclose each other’s HIV test results, help to cope if one or both receive a positive result, and make planning for the future a shared responsibility.
Everyone who is not aware of their HIV status is encouraged to be tested for HIV as it is the critical entry point into care, treatment and support.
Clients who test HIV negative will be couns positive clients will be linked to care and counselled to start lifelong antiretroviral treatment (ART) as soon as possible.
HIV testing is recommended for everyone at least once annually depending on the risk. For young adults, getting an HIV test before marriage is a good practice as it empowers one to make decisions on HIV prevention within the family.
Should one of the partners test positive to HIV, that person is not facing a death sentence. The couple should go for professional counselling to help each of them to deal with this.
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Nurses and doctors at most health facilities have been capacitated to give the best advice regarding general HIV and health issues as well as HIV prevention methods that can be used in a discordant relationship.
The HIV positive partner should be initiated on antiretroviral therapy (ART) and should adhere to treatment.
Taking antiretroviral medicines is good as it will lower the amount of HIV in the body.It can reduce the virus to very positive partner less likely to pass on HIV to the negative partner and prevents further HIV disease progression hence reducing the risk of developing opportunistic infections like TB.
It is encouraged that the HIV negative partner supports the one who is positive as much as possible to allow a smooth flow of treatment.
Another key issue amongst discordant couple is the correct and consistent use of condoms every time they have sex.
In addition, partners need to discuss HIV prevention and family planning together as a couple, and with a healthcare professional.
It is important to plan pregnancies so as to protect the HIV negative parent and their baby from HIV. To avoid unplanned pregnancies, health care professionals will help couples to choose methods of family planning.
When a couple is ready to have children, the nurses and doctors at the nearest clinic will give you advice on the best timing not to use condoms so that you maximise chances of conception while minimising the risk of HIV transmission.
To minimise the risk of HIV transmission, it is recommended that this timing should be when the HIV positive partner has an undetectable viral load for six months, has good adherence to their treatment and has no sexually transmitted infections.
Having an HIV-negative baby is possible with careful planning and a couple may have as many children as they wish.
Another method of HIV prevention that is available to the HIV negative partner in a discordant relationship is taking ARVs to prevent HIV infection. This is known as Pre-exposure prophylaxis (PrEP) and it is recommended for all sero-discordant couples.
PrEP is taken during the period of substantial risk, for example when a couple is trying for a baby. Any health facility in the country can provide more information and access to PrEP.
I hope that after reading this article, Dear Reader, you and your partner will go for an HIV test if you do not know your status.
—NAC communications desk
