Mr Chilala stood frozen for a good few minute but it felt like 24 hours. He stood there looking at his results and wondering what to say to his wife. They had just celebrated their Rubee Jubilee anniversary and their children had thrown them a grand party in Livingstone and the party on a boat cruise. 40 years later in marriage, with 7 children and 15 grandchildren. He vividly remembered the smile and pride on his wife’s face when the kids sent them air tickets and hotel reservations for the Livingstone anniversary party. And while in Livingstone, on the boat, they further surprised them with tickets to Paris. It was his wife’s dream to visit the land of love and he was also looking forward to being a tourist finally.
It was his wife’s idea that he visits a doctor due to a persistent cough that wasn’t going away even after some antibiotics and natural home cough remedies. After explaining his ordeal to his doctor, which included lots of night sweats, the doctor asked him if he was ready to do full tests which included an HIV test and he had no issues with that. The only other woman apart from his wife that he was sleeping with was a young lady at the farm who was a decent looking bar lady at the neighbourhood bar. His wife hardly went to the farm as she spent most weekends resting with her friends as she looked after her grandchildren during working days, so she had no idea what he was up to at the farm. The relationship at the farm with the young lady made him feel young again. It made him resume exercises and he begun to take care of his looks. He became known as the smart old man, all thanks to him trying to impress his young bouncy lover. His visits were now more frequent, and he started spending weeks and not only weekends and his business at the farm started booming since he was often there to supervise the workers, something also which impressed his wife. How was he going to tell his wife was the question that kept popping in his head? What about his children? What would they think of him acquiring the virus in his old age.
Cynthia was on her second pregnancy and had just gone to register for antenatal. Before she realised, she was pregnant, she had been hit several times with boils on her buttocks and thought it was the soap or lotion she had changed. She had even reached a point of resorting to use baby products thinking she had developed very sensitive skin and because she had been banting trying to lose weight. Her friends had mentioned to her that banting induces all sorts of reactions so she didn’t worry much about the boils. Now that she had started antenatal, it was time for the mandatory HIV testing after the usual counselling. When her results were issued to her, she felt her entire dignity and pride leave her body. Was she dead or was she dreaming because she could see faces but hear no voices. She could hear her own heartbeat but could not feel anything else or hear other sounds. Her whole life flashed before her, she remembered her wedding day, the joys on her mothers look even though her mother was sickly and fragile. She remembered the first time she held her first born, she remembered her honeymoon night. She got married as a virgin and her husband Jack was the first and only man she had ever known. How was this possible, how could he do this to her?
Cynthia had nursed her mother after the demise of her father and her mother did not keep the fact that she was HIV positive a secret. She nursed her to a point where she would mess herself in her pants and Cynthia was the only one who could bathe and clean her mother. If there was something she vowed, was to marry a faithful husband and to be faithful herself so that she never had to go through what her mother went through. Cynthia and her mother lived in the rural parts of Zambia in Western Province and travelling to collect medicines sometimes was not possible especially when it was rainy season, and they had no money to pay for an ox-wagon so she was not consistent with her ARVs. And when she met Jack, he was heavenly sent as he was a clinical officer who started giving her more meds so that she did not make frequent trips to the hospital and in a few months’ time, they were husband and wife and relocated to Lusaka.
As Cynthia got home that afternoon, looking at her meds, she quickly thought of going through Jacks items. She unpacked all his old laptop bags and came across his medication, the exact type she had been given. She knew those meds from administering them to her late mother. How could he? Why me lord, she cried! The pain was unbearable, and Jack was out of the country on a work mission. She started battling with her breath, her blood pressure was going up, she asked the garden boy to drive her to the nearest hospital. Halfway to the hospital, Cynthia took a deep breath and closed her eyes for good. It wasn’t the virus that killed Cynthia, it was a heartbreak of knowing Jack hid his status from her.
Sharing one’s HIV status with anyone is hard but telling a spouse or sexual partner is particularly very difficult. People are often scared of rejection and hurtful reactions that they fail to disclose their status. Disclosing one’s status needs to be navigated in a manner that makes one feel safe and confident. The prevention and control of infection depends on the success of combating new transmissions. In HIV infected individuals, status disclosure is of prime importance to their sexual partners as it motivates testing and changes behaviour.
There are many barriers to HIV status disclosure such as fear of being abandoned and losing economic support from a partner. The fear of rejection and discrimination, fear of violence, upsetting family members and accusations of being unfaithful or infidelity. The questions of how you acquired the virus will always arise. There will be concerns about whether you have passed HIV on to your partner or whether you could in the future especially if they are not aware that effective HIV treatment prevents this. While sharing one’s status can be difficult, it gives an opportunity to speak about ways in which your partner’s health can be protected. Timing is very important, it’s difficult to talk about HIV when you have just met someone but putting it off may cause problems later, so upfront disclosure may be helpful. You may find that upfront disclosure filters out people with discriminatory beliefs.
Often times, sex happens in the heat of the moment and it may not give you an opportunity to mention that you are HIV positive or your partner may not want to discuss it. You may also find that your partner initiates sex without protection. Just because your partner is not talking about HIV and is willing to have live sex must not make you assume anything about them, be the responsible one and bring about the condom use.
It is only morally right for a spouse or partner to share their HIV status and ensure proper safety precautions are taken. It would be helpful to disclose with the help of your doctor by asking your partner to join you at the hospital so that a therapist counsels you both. And make sure you have a support system in case your partner struggles to accept the situation. Your partner needs to be allowed the time and process the news and be allowed to feel the negative emotions as they come up.
Living with HIV and disclosing to a partner or loved ones can give you a shoulder to lean on and keep them informed of any potential implication. By sticking to treatment on schedule, you and your partner can have sex with almost no chance of passing on the virus. The first step is informing one’s partner so that steps are taken on how you can still be intimate, take HIV drugs called antiretroviral therapy (ART) which lower the virus in the blood to low viral loads that it can be undetectable with tests hence making possibility of transmission extremely low. And even when the viral load is low, use condoms correctly to protect yourselves from other sexually transmitted diseases. Your partner could also start PrEP, a medication that allows people who don’t have HIV stay HIV negative when taken as directed.
While we have advanced medications that are giving a high life expectancy to HIV positive people, the stigma and stress from the diagnosis takes a toll on the quality of life. You find the positive individuals begin to stigmatize themselves by assuming people will think they were promiscuous once they learn of their status. Stress can work against your health and trigger a lot of other chronic diseases such as cancer or cardiovascular diseases. A daily reminder of taking the pill can be a difficult reminder but one which one must face and now with the injectable drug (speak to your doctor on eligibility), it acts as an alternative therapy from taking pills daily. While drugs keep the viral load suppressed, its up to us to ensure we maintain our health by adhering to treatment plan, getting mental health support if feeling low or stressed, stop smoking and abusing substances, start exercising, join a support group and practice self-care by eating well balanced home cooked meals bearing in mind that food eases medication side effects and supports one’s immune system.
Seek help when in need, visit a counsellor near you!
About the author
Aka Monde, is a licensed Professional Counsellor who holds a Master of Science in Counselling from the University of Zambia. She believes in the adage “a problem shared, is a problem half solved.” Speak to your pastor, church elder, elderly family member or see a professional counsellor when in need.
Email: [email protected]
