KHOPOTSO: Discordancy or a non-matching HIV status in couples is a reality. But the cause of that remains a mystery. Dr Yaw Adu-Sarkodie, formerly a Senior Researcher at Wits University’€™s Soweto-based Reproductive Health & HIV Research Unit, says a number of variables come into play in facilitating HIV transmission.

Dr YAW ADU-SARKODIE: We know, for instance, that if one of the partners has a sexually transmitted disease and HIV as well, it is easy for them to pass on the HIV. It   also could depend on your immune status: if a person’€™s immune status is very low, it’€™s easier for them to contract the HI virus. Even genetic factors: it is believed that genetic factors are involved in HIV transmission and that some people may have certain genes which do not easily allow HIV transmission.

KHOPOTSO: It is also not clear if the delay in HIV transmission is temporary or permanent. For that reason, couples are encouraged to find out about their own and their partner’€™s HIV status. This is called Voluntary Couples’€™ Counselling and Testing (VCCT). Phindile Hayo is a counsellor at New Start, a non-governmental testing service, in Johannesburg.

PHINDILE HAYO: You’€™d find couples with different results, therefore it is important for them to come together for a test or they can even do it individually. But what we say (is) it doesn’€™t necessarily mean if you test (that) it determines your partner’€™s HIV status as well.

KHOPOTSO: A number of couples find themselves in such a situation. Thirty-seven year old Thabang lives in Orange Farm, in the south of Johannesburg. For a long time he refused to heed his partner’€™s advice to go with her for an HIV test.      

THABANG: But when some other man now tells me the same thing, I decided, ‘€˜okay, let’€™s move on’€™. We made a day to come here, then we found out that day.

KHOPOTSO: The result came back positive. Surprisingly though, Thabang’€™s partner, Mmapaseka, had tested a couple of times before and all her results have been negative.

MMAPASEKA: Three times now, I went to the clinic and I’€™ve told myself that he’€™s (al)right. He’€™s not positive because I’€™m not positive, I’€™m negative. (That was) until we got here. He has a virus, I don’€™t have a virus.

KHOPOTSO: Health experts advise that every couple must test together for HIV. The knowledge of your partner’€™s status, whether positive or negative, could be deceiving if you don’€™t know your own status, as it’€™s not always a true reflection of a couple’€™s HIV status. In the case that either member of the couple is infected, testing together could be beneficial for a host of reasons, including helping minimise the risk of infecting the other. Sammy Nena is the out-reach services co-ordinator at New Start.

SAMMY NENA: It’€™s important that you break down their sexual behaviours, such as oral sex. They think that if they practice oral sex, they’€™re more safer than when they practice penetrative sex, which might be vaginal to a penis’€¦ At times there’€™s also anal sex involved. Also, there are actually implications of anal sex if you don’€™t really understand what are the dangers of you practising anal sex’€¦ And also try to bring in the issue of condom usage as to when to use a condom and why is it important also to use a condom’€¦ The issue of (a) condom can come in to oral sex. If, let’€™s say, in case a partner has got a bleeding gum, obviously the other partner will be transmitting body fluids from his or her organ to their mouth. So, in that way you can actually get infected. So, those are the things that we primarily discuss.

KHOPOTSO: A young couple, Koketso and Lefa, have recently had their HIV test together after only two months of dating. They share with us their theory.

KOKETSO: I wanted to protect myself and to protect my partner. So, the best way to do that is to find out if I’€™m positive, so (that) if I’€™m positive I can protect him. If he’€™s positive, for him to protect me.

LEFA: It takes the relationship on to another level, especially knowing your status. If you come out HIV-positive and your partner’€™s there, then they realise that they’€™ve got no other option but to support you and to help you’€¦ Finding out that you’€™re HIV-positive on your own is very hard. But if you’€™ve got a support basis, it makes things a lot better.  

KHOPOTSO: For the pair, open and frank communication between couples is absolutely necessary to get around the issue of testing, even if it involves bringing up the subject that some love to hate ‘€“ past relationships.

KOKETSO: I think that if you have a choice between being alive and talking about past relationships, you will choose to be alive. So, you will talk about the past relationships that could potentially affect your life.  

LEFA: (He laughs) You need to know where the other person comes from because if they were in a relationship that was otherwise you know what to expect, to a certain extent. If that person was dating, like, a gigolo you know what to expect. They’€™re obviously not going to trust you for a while. You’€™ll have to prove yourself, dah-dah-dah-dah. So, it is important to talk about your past relationships.