“My fiancée is HIV +…”

Last Saturday, I was a member of a panel of discussants at a youth forum. One of the questions that came via SMS was from a young man who claimed his fiancée is HIV positive, what should he do? In my response, I said the first issue is, does he love the lady sufficiently enough to want to spend the rest of his life with her? If the response is yes, then he should deal with the HIV issue along with the other issues people involved in courtship should deal with.

First, courtship is a time for them to get to know each other well enough to decide whether or not to get married. Do they share similar interests and core values? Are they friends? Are they ready to put up with each other’s short comings for the rest of their lives…? Marrying an HIV positive person does come with sacrifice and strict discipline, but the couple can live normally like other married couples and give birth to HIV-free children.

Other panelists spoke in similar vein, with the reverend gentleman in the panel stressing the importance of the sacrificial nature of marital love. But one young man in the audience would have none of it. As far as he was concerned, we were talking theory. He said in practice nobody would take that “dangerous” plunge. He said he cannot even mention it to his parents, neither can anybody. I would have let the matter be, but he got a lot of applause and “go on” from the audience, which means, that is probably also the thinking of many people.

Now, let us leave prejudice and look at the facts. The human immunodeficiency virus (HIV) is the virus that causes HIV infection and acquired immunodeficiency syndrome (AIDS). The virus can be spread through blood transfusion, seminal fluid, vaginal fluid and breast milk. AIDS did claim many lives in those days (about 35 million people worldwide with sub-Saharan Africa accounting for the bulk as at 2012), but over time, it is no longer the death sentence it used to be.

However, there is still no cure for AIDS, but effective treatment with antiretroviral therapy (ART) can suppress the virus and help people with HIV live healthy, normal and productive lives. What challenges do HIV negative people with HIV positive spouses face and how do they overcome them? To start with, unprotected sex is out of it. Such couples should engage only in safe sex, that is, using condoms, to protect the HIV negative spouse.

Living with HIV and deciding to get married presupposes that you have chosen the option to live and therefore you are on ART, which reduces the amount of virus in your blood and body fluids. The treatment also greatly reduces the chances of transmitting HIV to the HIV-free spouse because of the reduction in viral load. One bitter truth, however, is that as long as there is sexual intercourse, the HIV-negative spouse is exposed to infection.

Some experts therefore advise that the HIV-negative spouse should take an HIV-prevention pill a day. Where there is reasonable reason to believe that the HIV-free spouse is exposed if, for instance, the condom breaks during sex, they should contact their physician immediately who will place the concerned spouse on the necessary drugs also referred to as post-exposure prophylaxis (PEP). So an HIV positive and HIV negative couple can have an active sex life.

For the full story, check the Vanguard newspaper.