The challenges of HIV sero-discordant couples


First, let us dispense with definitions. The World Health Organisation (WHO) defines discordant couples are those where one partner is HIV-infected and the other is not, where a couple is defined as two persons in an ongoing sexual relationship and each of these persons is referred to as a “partner” in the relationship.

In my early years of living with HIV, because of ignorance, I believed a person infected with HIV could only be in an intimate relationship with a partner of likewise HIV status. My misconception had lots to do with the stigma I was subjected to after testing HIV-positive. Which completely messed up my mind. I felt like no HIV-negative man in his right mind would touch me.

Thank God for medical progress and attitude adjustments. Over the years, many myths concerning HIV have been debunked. And this sister has been proposed to by brothers. Numerous brothers. HIV-positive, negative and ignorant.


In 2012 WHO released its new “Guidance on couples HIV testing and counselling, including antiretroviral therapy (ART) for treatment and prevention in serodiscordant couples.

In part, it stated that, “Couples who test together and mutually disclose their HIV status are more likely than those testing alone to adopt behaviour to protect their partner.

In addition, in a serodiscordant couple the provision of ART to the positive partner can significantly decrease the risk of transmission to the negative partner, or, potentially, the provision of antiretrovirals (ARVs) to the negative partner— termed pre-exposure prophylaxis (PrEP) — can help to prevent HIV acquisition”.

It further maintained that, “another potential benefit of couples testing together and sharing their results is that they can support each other, if one or both partners are HIV-positive, to access and adhere to ART and interventions to prevent mother-to-child transmission (PMTCT) of HIV”.


Four months ago, a reader wrote to me about the plight of their serodiscordant relationship. The issues he shared are, I suppose, unique to only sero-discordant couples.

“I’m moved by what I’m reading in today’s nation newspaper about you,” he wrote. “My lovely wife has lived with HIV for slightly over a decade ago now. I’m HIV-negative. I’m 50, while she’s 10 years younger.”

“I learned of it only when I took her to hospital to have our lastborn daughter, who’s now in lower primary. The sad part is, besides knowing her HIV-positive status from the doctor during her clinics, she kept it to herself.”

“My concern is, even today, after her voluntary counseling and testing (VCT) visits she doesn’t tell me anything. I once requested to know how she was progressing. Her answer was, ‘This is personal and should you dare ask again, then that’s a police case’.”

“I’m indeed going through a hard time. Sometimes I look sicker than her. I need your ADVICE. Please.”


Speaking from personal experience, and I’m not defending this woman’s actions; HIV can mess up a person’s mind. It seems to me that, in this woman’s mind, her husband’s crime is he is HIV-negative.

There were days, before I started living positively, that I perceived HIV-negative persons as us versus them. I got it: they couldn’t get it. They were having one helluva time: I was going through hell. They could not understand what I was going through. They were on the inside looking in. Now I know better. If our response to HIV has to work, we must walk together. There is no us or them. We are not all infected, but we are all affected.

Talk, talk, talk

Talk ain’t cheap. Especially when we’re talking HIV-related issues. In most HIV support groups, there are group sessions that cover a broad spectrum of HIV-related issues; sero-discordant couples notwithstanding. From reading between the lines, there seems to be a complete communication breakdown. Sharing issues with people going through the same issues and with a counsellor can help sero-discordant couples to find method to the madness.

News flash. This is no longer a personal; but a family issue. My bad. It’s a global issue. That’s all I’ll say about that.

It takes two. The WHO affirms that, “testing an HIV-uninfected woman’s partner can help identify women at risk during this especially vulnerable period and so can help to prevent infection in both the woman and the child.”

There’s an adage that says “a drop of water hollows out a stone, not by force, but by constant dropping”. Man, constantly talk to your wife. Keep “dropping”. She will come round. You’ll hollow out your lovely wife’s temporary stony disposition. Ultimately.