HIV discordance among couples is a situation in which one partner is HIV positive and the other negative. Among married or cohabiting couples in the general population in rural Uganda, 5–7% were estimated to be HIV sero- discordant according to the HIV/AIDS Sero- Behavioral Survey 2004–2005.
Since 2005, Reach Out Mbuya has registered a total of 292 discordant couples and has engaged them in various trainings to help them better understand and accept discordance. The trainings aim at creating awareness of HIV discordance and letting them know that they are not alone, while creating a peer support program for the couples.
For these couples, ROM conducts a 3-month modular risk reduction training aimed at preventing HIV transmission to the negative partner and children in the event of pregnancy. ROM also conducts an annual discordant couples meeting to strengthen support and adherence for this group. In 2015, 508 home visits were also made to 166 discordant couples by community health workers.
The trainings includes modules like; Importance of communication in discordant relationships, ART and the importance of supporting the positive partner on treatment, risk reduction measures to the negative partner, dangers of alcohol, as well as family planning and PMTCT.
In 2015, 99 new discordant couples were linked to ROM’s 3-month training program. At the end of the 2015 training, 50 partners who were originally HIV-negative were retested, and only two (4%) tested positive.
Conversation between a discordant couple
“When Solomon and I started living together, I requested that we go for an HIV test together because we loved each other dearly and wanted to settle in a family way. He gladly accepted my request and we agreed to visit Reach Out Kinawataka, where we were tested and given different results.”
“Upon receiving the results, I asked myself “why me?” and I was confused with the thoughts that my wife would leave me. Upon counseling, my wife assured me that she would stay by my side, because if she was the one found positive she knew I would stick by her. Since then, she has been my home counselor, encouraging me and reminding me to take my medication.”
“A part of me wanted to leave him and start over. The other part questioned whether leaving him was a guarantee that I would never contract HIV. My heart suggested that l overdose on a drug and kill myself rather than lose the man that I love. Upon counseling, most of these doubts were cleared, and I realized that we could live as a normal family if we abided by the guidelines that the counselor was highlighting.”
“I started taking my ARVs as I was told and have become stronger than I was initially. I have learned that HIV is not the end of the world if I adhere well and keep all of my appointments. ROM invited us for discordant couples training, where we realized that we were not the only couple in a similar relationship. This has helped us share experiences with these various couples who have encouraged us as well and have been a source of inspiration to us.”
“My husband was stared on ART immediately, and since then we have not had problems of sickness. I love my husband and will stay with him as well as care for him for the rest of my life, because it was God’s plan for me and him, and nothing can be done about it.”
“I thank ROM for the trainings that they give us as discordant couples, because they help us understand this impossible occurrence. I request that they extend the training program to the community to help those affected but who still face stigma and can’t come to the clinics. It is important as well to educate people that discordance is real.”
“I thank ROM for the help it is giving so many people, and especially taking time to counsel us and help us understand some situations like discordance and pray for its continuity.”