Over 10 years as a discordant couple

Marie Anne Dushimimana

When Kimonyo (not his real name) knew that he was infected with HIV, it was like a year after his first wife had died, and he was already living an informal marriage with another wife.

Kimonyo from Nyarubuye sector in Kirehe District tested positive in 2005 after losing his first wife without knowing any reason.

At that time, he said, when people died from AIDS, the society blamed it on witchcraft, and it was the case for her wife, he said.

It wasn’t until his friend approached him and advised him to conduct a medical test that he found he was already infected with HIV.

“It was like the whole world was falling on me, but one neighbor who was also HIV zero positive approached and helped me to accept my situation. He recruited me into an association of people living with HIV until we got the help of Partners in Health,” he said.

After being aware that her husband was infected with HIV, the wife didn’t leave him, and she even tested negative, he said.

His wife was not free to talk to the media, but said her husband could talk on her behalf.

“At first, we protected ourselves during sexual intercourse using condoms, but later we failed and started doing unprotected sex. When people live together, it’s very difficult to protect them always.  We take the decision to do so, but sometimes we get tempted, and that’s how she even gets pregnant and we have safe babies,” he said.

In 2010, they got married legally, and now they are still struggling to remain a discordant couple.

“I think there is no specific method to remain discordant, but if you take medications effectively for a long time, by chance you can live with someone and you don’t transmit the virus to him or her,” he said.

“Most of the time, we protect ourselves, but when we need a child, we plan. I think it’s by chance if today she is not infected yet,” he added.

What is sero-discordance?

By definition, sero-discordance is a situation where two people are having sexual intercourse 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 for some people it can be exceptional, medics say.

Joseph Muganda, an obstetrician at Clinique la Medical, says when the infected person is under Antiretroviral Therapy (ART), the risk of transmission is low.

However, there is no type of blood that can’t be infected with HIV, as people used to say, Muganda said.

« When we find a discordant couple, we advise them to protect themselves by using condoms on a regular basis. It’s the only way to help the uninfected one to remain safe, » he said.

Besides, if a male partner is circumcised, the risk of getting infected or infecting his female partner also becomes low, as studies show.

If in a discordant couple the wife is sero negative and she gets pregnant, she has to take ARVs to avoid that she can be infected and transmitting it to his fetus, he said.

Sero-discordance in Rwanda

Ernest Aimée Nyirinkindi, in charge of Behaviour Change and Communication at RBC, said on a national level, there are more than 18 thousand discordant couples.

To be able to continue with their status, intense follow-ups on their lives have to be made, on a regular basis, Nyirinkindi said.

In the hospitals and health centers 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 seropositive 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 to keep safe the one who is still zero negative,” he said.

These follow-ups should help them to live together all their lives without infecting each other, he said.

Counseling, putting on ARVs the infected ones, telling them to help each other, continuing the good habits to effectively take drugs, and meeting medical appointments are among the methods used to help them, he said.

“We always tell the ones who are infected in discordant couples to remember that they must protect their loved ones from getting HIV,” he said.