WHEN OPPOSITES ATTRACT……

Doreen is a happily married mother of two. She gushes through life full of energy and juggles work, school, motherhood and wife roles just perfectly. She is also a counselor at her church.
What most people don’t know about Doreen however is she is HIV positive. In a country where about 1.4million Kenyans are living with HIV, this could be the story of many other women Doreen’s age.
What’s unique about Doreen’s story however is the fact that her husband of over ten years is HIV negative.

“I found out about my HIV status three years into my marriage.” Doreen narrates.
“I was devastated, back then people were not as informed as they are now.” She continues.
On breaking the news to her husband, he was supportive in all aspects and their lives moved on. Her husband refused to go for the test believing that if his wife was HIV positive then he was too.
“So for the next 6 years we have been living as though we are both HIV positive. We used Condoms and looked out for each other” Doreen explains.

Last year Doreen’s husband got tested for HIV after yielding to constant nagging from her and their Doctor.
“He tested HIV negative” Doreen reports with a beaming smile.
This new occurrence left this couple with a lot of more questions than they thought possible. Well, with the help of their doctor and a counselor Doreen and her husband are happy and going about their life. Nothing much about their lives has changed,
“In-fact we have never been more optimistic. We want to try for another baby.” She shares.


Doreen is not the only person in this kind of relationship. Jane, Lucy and George are both young people aged between 28 and 36 and are HIV positive. There is nothing any different about their lives. They are all well educated, have good jobs and live a good life. What they have in common is the fact that they are all dating HIV negative partners.
Jane has been dating her partner for the last two years, Lucy has been married to hers for a year and George is getting married to his partner with whom he has two beautiful baby girls in August.

There is an increasing trend among young people to go for counseling and testing and this is leading to a lot of couples finding out that the person they just started dating or are intending to marry are HIV positive. While some dating relationships may not survive the revelation that one person has HIV, there are those that withstand the confusion and emotions surrounding the discovery of HIV discordance. Then there are couples who like Doreen find out their HIV status after years of marriage and chose to stay together with their partners.

According to the recent Kenya Aids Indicator Survey released in 2009, nearly 350,000 cohabiting or married partners were ‘discordant couples’. Meaning one of the partners is HIV positive and the other negative.

Having a discordant relationship comes with its own set of challenges. For most discordant couples there is always the worry and questions around , how to have HIV free biological children, preventing HIV transmission to the HIV-negative partner; the future health and survival of the HIV-positive partner; and future investments to take Care of the surviving partner and/or children.

Contrary to what people think, discordant couples can have a long term and mutually satisfying relationships. Just as it is key in every dating or marriage relationship, the key ingredient to a happy fulfilling relationship as discordant couples will be open communication. Couples living in a HIV discordant relationship can make the most of their time together and lead a healthy loving and fulfilling relationship if they are were informed about HIV&AIDS and the various aspects that it could affect their lives. Here are some of the common questions asked and helpful answers to them. Remember, the best person to have a complete talk with about any of these issues is your doctor or counselor.

Is it safe to live together?
Living with an HIV positive partner is just as safe as living with an HIV negative partner. Both of you need to know as much about HIV&AIDS as you can to be able to cope. Dealing with a positive diagnosis and coming to terms with the challenge of living with HIV/AIDS is never easy. But today the prospects for successful treatment are better than ever before, and there are a wide range of support services available to help people living with HIV/AIDS in Kenya lead a normal productive life.
Learning about your HIV diagnosis or your partners can feel overwhelming. The battle of emotions always range from feelings of fear, anger, confused, despair among others. This is normal. It’s like joining a new school. No one really knows what is expected of them. Often times one feels lost; it’s okay to ask for help.
Mrs. Owino my class one teacher took me through the basics of life. She taught me my first real math and made science exciting.
“Cleanliness is next to Godliness.” She would say as she taught us to brush our teeth after every meal and wash our hands after we visited the toilet. She had a graphic demonstration of what would happen to us if we didn’t do as she said. Using pictures from some book she would tell us how our dirty hands would carry germs to the food that we eat and then we would have diarrhea and look thin and ugly and before long all our family members would be sick too. Those pictures made you tow the line.
Two decades later, I brush my teeth and wash my hands just as Mrs Owino instructed. I bet the curriculum then put all these demonstrations to help us understand well why we needed to be clean and healthy. I wonder if Mrs Owino would be talked into doing a demonstration to the same people she taught ages ago to show us how HIV “really does get in” to our bodies. But while these simple messages have their place, the truth is of course more complex. If we take the time to understand how HIV is – and isn’t – transmitted, we are that much better armed to live with and protect our partners.
HIV is found in many of the body fluids of people who are infected with the virus. It can be found at varying concentrations in blood, semen, vaginal fluid, breast milk, saliva, and tears. It cannot be found in sweat or urine.
A simple explanation would be to say that the virus can be transmitted if any of those infected body fluids pass from an infected person to an uninfected person. This risk varies with circumstances such as the stage of HIV progression and viral load of the person living with HIV among others.
To start with, there have been no cases recorded of HIV transmission from saliva or tears, so they can safely be crossed off the list. This is to be expected, as the quantities of virus which have been observed in these fluids are extremely low. This is good news for those of us with HIV because it means there’s absolutely zero risk of passing on the virus through casual contact including kissing, hugging, or sharing eating utensils.
That leaves blood, semen, vaginal fluid and breast milk as the remaining body fluids which have been significantly implicated in transmission of HIV. We know from both laboratory experiments and real-world observation that virtually all HIV transmissions can be attributed to one of these four.
It is important that the discordant couple also be aware of non-sexual transmission of HIV, and reduces risk accordingly. For example, the couple needs advise on how to clean products that may have infected fluids, how to deal with blood spills, not to share tooth brushes, razors etc. It can be particularly challenging in a family setting especially with children around but can certainly be done.

What treatment options do we have?
There are various treatment options for People Living with HIV (PLHIV). We don’t have a cure yet but there are a variety of medications that one can take to be able to live well. The Doctor will advise after carrying out a number of tests on whether one needs to start their Anti Retroviral (ARV) medication. Couples need to talk about these medications and their implications on their relationship. For instance there are certain ARV’s that are not recommended for women who want to have babies or for pregnant women. For those who aren’t on ARV’s then a prophylaxis to help the body fight diseases may be prescribed as well as immune boosters where necessary. The Partner living with HIV will need support from the HIV negative one to adhere to medications.
In the occurrence of any exposure to the Virus, for example through a condom burst during sex or cuts and injuries in the house, the HIV negative partner can access Post Exposure Prophylaxis (PEP).
PEP is short-term antiretroviral treatment to reduce the likelihood of HIV infection after potential exposure.

Can we have biological children?
Babies are a blessing and every couple wants to have babies of their own by every means possible. HIV discordant couples are advised to use condoms every time they get intimate and are therefore at loss at how they will be able to have biological children. Having a biological child is possible and if done with the help of doctors then measures will be taken to ensure that the baby is born HIV free. It’s advised that couples seek preconception counseling for HIV discordant couples; information on pregnancy planning, preventing transmission of HIV to the partner and the baby, and nutritional and lifestyle advice will be shared. It is advised that couples attend these sessions together.

How do we have a normal and happy marriage?
Open communication is encouraged in all forms of relationships and marriage. In HIV discordant relationships it is encouraged to talk about everything.
Disclosure of HIV status by the partner who is HIV +ve to the HIV-ve partner is encouraged as this is key in the couple making informed choices about being safe and protecting themselves. For people who are not in an established relationship or are doing the dating scene, disclosing their HIV status to another person is often difficult and requires quite a bit of courage.
Emotions that emerge from the discovery of ones HIV status and a couple’s discordance are many and varied. Couples should strive to share a lot during this process. Talk about your feelings for each other, for your relationship, for the way forward. Discuss your fears and try together to find possible solutions for them. Do not be afraid to get help if you need it. We have a number of Couple Counseling Centers within the Voluntary Counseling and Testing centers.
Discuss all of your concerns upfront before deciding the next course of your relationship or marriage. Let the HIV negative partner reassure the one who is HIV positive that you are seeking to be educated and are not trying to pass judgment. Issues that worry discordant couples on sexuality and reproduction as well as planning for the future need to be openly discussed as frequently as both partners want.
Ask candid questions and make sure you are completely at ease before either of you makes any decision. Reaffirm your feelings for each other if they still exist. This is important especially for the HIV positive partner who may be apprehensive or scared that their disclosure will make their negative partner desert them.
Reach out for help whenever you need it. Your doctor can refer you to places where you can get more counseling and whatever other help you may need as couples.

People say, “love knows know boundaries, distance or time.”
I wonder how true that is when HIV&AIDS becomes something two people in a relationship have to deal with. But if the statistics on the number of discordant couples in Kenya is anything to go by, maybe opposites do attract.
Every time I meet Doreen and any other HIV positive person happily married or dating HIV negative people, I am reminded of Iannis’ description of love off the movie Captain Corelli’s Mandolin
"Love is a temporary madness. It erupts like an earthquake and then subsides. And when it subsides you have to make a decision. You have to work out whether your roots have become so entwined together that it is inconceivable that you should ever part. Because this is what love is. Love is not breathlessness, it is not excitement, and it is not the promulgation of promises of eternal passion. That is just being "in love" which any of us can convince ourselves we are. Love itself is what is left over when being in love has burned away, and this is both an art and a fortunate accident.”