Having given her the love and support she deserved, Peter found it difficult to reconcile his wife’s action.

“I loved her so much that I did not want to send her away. Confusion overwhelmed me for sometime before I made a decision about how to move forward,” said Peter while sharing his predicadiment with a counselor at Kenyatta National Hospital (KNH) Voluntary Counseling and Testing (VCT) centre.

The move to visit the VCT resulted from Peter’s fear and suspicion that his wife’s short fling with another man might have exposed her to HIV. He suggested that they both go for an HIV test at a nearby VCT.

The tests results proved that Peter was HIV negative, and his wife positive or what would be categorized as discordance by Aids experts.

At first, the wife did not accept the results, and they decided to try other VCT centres for confirmation and invariably, the verdict was the same.

Still in denial, they decided to give the KNH VCT one last try where Peter’s fears about his wife’s HIV status were confirmed beyond any doubt. At this point, she accepted the results, but in private, pleaded with one of the counselors to talk to her husband and convince him to continue loving and supporting her.

On the other hand, the husband was devastated and his initial response was an outburst of anger. He was also confused about what to do next, and after being counseled, he left without saying a word.

Several days later, he came back to the VCT to find out how he could help his wife cope with her HIV status. This, Ms Lena Agare, a counselor at KNH VCT says, was the beginning of important developments in the couple’s life.

Since then, Peter has accompanied his wife to her sessions with a support group, offering her a shoulder to lean on. When she is down with opportunistic infections, he takes the responsibility for coming back to the VCT to enquire about what to do.

Even though he is not infected, he attends support groups to know how to better handle his wife’s condition as well as listening to her.

Counselors at KNH VCT say they find him even more outgoing than the wife when it comes to exploring more about coping mechanisms for HIV infected and affected people.

“The wife usually calls to enquire if Peter has attended the support group sessions. And she does not hide the fact that his immense financial and emotional support, gives her hope to live one more day,” says Ms Agare.

Peter’s action may appear unusual for majority of Kenyans. Ordinarily, when women turn out to be HIV positive and their husbands’ negative, the immediate expected response from their spouse is a violent separation.
But Peter has demonstrated that men need not be violent just because their wives or girl friends are HIV positive. Although such cases are rare, there is a slow but steady increase.

Take Agnes’ case. When she shared her HIV positive status with her family members, her family was outraged. The realization that her three-year-old son whom she conceived out of wedlock was also positive deeply angered her father.

Later, after sobering up, the father called all other family members, and asked them to support her.

To Agnes, this was the starting point for the overwhelming emotional and financial support her father and the entire family have given her.

“When I am engaged elsewhere he takes my son for check-ups. He also finances my son’s medications and provides our nutritional needs,” she says with a shy smile.

Both her father and brother, she adds, are the best thing that ever happened to her. “I did not expect such support to come from my family members, especially the men.”

In another case, a fourth year male student at University of Nairobi told counselors at one of the VCT centres in Nairobi how he was willing to support his HIV positive fiancée, who is still pursuing her studies at the same university.

All this happened a few months ago when the two went for an HIV test and it was established that the woman was HIV positive and the man negative.

When a counselor at the VCT asked him what he thought about the development, he responded, without hesitating: “I will support her because I love her so much.”

Ironically, in premarital cases, while men come-out to strongly support their fiancées, women take-off when they realize they are HIV negative, and their boyfriends or husbands-to-be are HIV positive.

If they don’t do so immediately, experience has shown that majority will put-up with the man for a short while, before deserting him.

Interviews with some of these women reveal that most of them take such actions out of the fear that they will be unable to fulfill their desire to have children with an infected man.

According to Dr David Bukusi, KNH VCT Project Manager, counseling for couples who turn up for HIV tests is a priority to ensure they handle their test results in an amicable way.

With between 10 and 12 percent discordant couples at his centre, Dr Bukusi says communication should be paramount in any strategy designed to deal with such couples.

In recognition of this, the centre has been running a monthly post-test club for discordant couples: “There are times when a couple come to us for a test before a wedding, and if one of them turns out to be positive, we advise them to come for follow-up to avoid emotional violence. Instead of violence we have witnessed amicable partings of ways when the couple feels unable to continue with the relationship,” says Bukusi.

The experiences of VCT centres in Kenya show that the partner who is HIV positive is desperate for emotional support from their partner. And any attempt to split the two becomes a huge burden and can lead to depression of the HIV positive partner.

Dr Surenda Patel of MP Shah Hospital says communication is crucial between discordant couples need to support each other, and protect them from any behaviour that may make them vulnerable to HIV infection. Or lead them into thinking of violating the other partner, especially if the HIV positive person is of the female gender.

In their recent observation among clients, Dr Patel and Dr Moses Otsyula, the Head of Virology at Institute of Primate Research found that out of 31 couples they tested, 23 were discordant couples.

But what they found challenging is making these couples heed to what is communicated to them.

Dr Patel says 50 per cent of the discordant couples they counseled on safe sex dropped the idea of using the condom after sometime.

And in another observation, only one out of the 23 discordant couples who were advised to use a condom used it.

So critical is communicating to and managing discordant couples that the government, at National AIDS and STD Control Programme (Nascop) is also running special counseling sessions for at least once every month.

Yet, in most VCT centres, HIV experts say there are no counselors with training on how to handle and communicate with discordant couples.

---