Kimonyo (not his real name) a resident of Nyarubuye sector in Kirehe District got to know that he was infected with HIV a year after his first wife’s death. Unfortunately he had remarried and was already staying with his second wife. The cause of his wife’s death had remained a mystery and he never suspected that it could be HIV. This was in 2005 and at that time, when a person succumbed to HIV/ AIDS, society blamed it on witchcraft and this was the case when his wife passed on. When a friend advised him to go and test for HIV, the results of his status hit him hard. “It was like the whole world was falling on me, but one neighbour who was also HIV positive approached and helped me to accept my situation. He recruited me to an association of people living with HIV where we got help from Partners in Health,” he said. Ernest Aimé Nyirinkindi heads the Behaviour Change and Communication department at RBC. Courtesy. He was worried for his wife and wondered how she would respond to the entire situation. Fortunately the wife tested negative and the two are still living together as a couple. Kimonyo’s wife declined to say how she copes with her new situation and said her husband would speak on her behalf. “We use condoms, but at times we fail and in that process we have had children too but the good thing is that both my wife and children are HIV negative”. Although they are still struggling with living as a discordant couple, Kimonyo and his wife made a decision to legalise their marriage in 2010 and are still going strong. “I think there is no specific method on how to live as a discordant couple, and if you take medication effectively, there is a chance you can live with someone and not transmit the virus to them,” he said. What is sero-discordance? By definition, sero-discordance is a situation where two people are having sexual intercourses regularly, one of them is HIV-positive while the other is HIV-negative and the virus is not transmitted as usual. Normally, HIV is transmitted through unprotected sexual intercourse but some couples can live for years having unprotected sexual intercourse when one of them is HIV positive and the other is negative and the virus is not transmitted. Joseph Muganda, an obstetrician at Clinique La Medicale says when the infected person is under Antiretroviral Therapy (ART), the risk of transmission is low and adds that contrary to some reports there is no type of blood which can’t be infected with HIV. “When we find a discordant couple, we advise them to use protection during sexual intercourse. It’s the only way to help the uninfected one to remain safe.” Besides, if a male partner is circumcised, the risk of getting infected or infecting his female partner also becomes low as studies show. With a discordant couple, when the woman is sero negative and she gets pregnant, she has to take ARVs to avoid infection which she can transmit to the fetus, he explained. Sero-discordance in Rwanda Ernest Aimé Nyirinkindi, the head of Behaviour Change and Communication at RBC says at national level there are more than 18,000 discordant couples. For them to be able to continue with their status, intense follow-ups on their lives have to be made, on regular basis, Nyirinkindi said. In the hospitals and health centres across the country, there is a specific program to help discordant couples, so that those with HIV sero negative status remain safe. “When a husband tests HIV sero positive and the wife is still negative or vice versa, it doesn’t mean they stop living together as a family. We give them advice on how to behave in order to keep the one who is still negative safe,” he said. He also said that these follow-ups should help them to live together all their lives without infecting each other. Counselling, taking medication regularly are among the methods used to help them, Nyirinkindi said. “We always tell the ones who are infected in discordant couples to remember that it’s their duty to protect their loved ones from getting HIV,” he said. editorial@newtimes.co.rw
