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Discuss your HIV status before marriage

Whether you are dating for the first time, or planning to get married, it is important to sit down with your partner well before the wedding to talk about your HIV status as this may have a long term repercussion for you as a couple and as individuals.
As simple and uncaring as it may sound, imagine you are negative and do not know your partner’s status.
It is always better to assume they are HIV positive until you know their status.
Despite the COVID-19 pandemic that has affected the whole world, HIV/AIDS continues to be a one of the world’s major public health issues, with sub-Saharan Africa being the most affected region.
Health experts have maintained, whether there is someone you plan to be with for the long term or just have a casual encounter, that it is important for you to consider using protection or make your sexual partners aware of your status.
According to research, men make up slightly less than half of the adults living with HIV across the world, yet they account for nearly 60 per cent of the AIDS related deaths.
In most cases, choosing who to tell and when is a personal decision and you may often find yourself trying to balance honesty with protecting your right to privacy.
One health expert said it is normal to worry about the reaction or about encountering the stigma that surrounds HIV, but it is important to be brave and speak up, not only for your well being but for your loved ones as well.
However, we are living in the “u equals u era”, where we have seen that an undetectable viral load means the virus is untransmittable.
But even though many people understand this, there are still those who may be worried or unsure about having sexual contact with someone who lives with HIV.
Recently, the author received an email that expressed someone’s concern about people debating with passion DNA testing on different platforms of social media, yet another area of concern is how both men and women are going into marriage without disclosing their HIV status to their partners.
‘We plan to get married with my partner, but I have just discovered that she has been on antiretroviral treatment (ART) for the last two years and she has not disclosed her status to me. However, I have done two HIV tests in six months, which have come out negative. Should I confront my partner about it?’ asked the concerned individual in the mail.
While more than 90 per cent of women attending antenatal care services are tested for HIV, only 10 per cent of couples in Zambia have tested together for HIV with urban data on Zambia suggesting that more than 60 per cent of new HIV infections occur within marriage or among people in cohabiting relationships.
A marriage counselor said it is only normal to worry about fear of accusation of infidelity that surrounds HIV though what is more important is being concerned about how your status may affect your marriage and partner in future.
Phalesi Daka, who is also a psychosocial counselor, said it is true that people living with HIV can also test negative after testing and present with undetectable viral load that can lead them not to transmit the virus to their partner when they are on ART.
She said in her seven years of work experience, some people prefer to
disclose their status to a potential date or sexual partner immediately, sometimes even before a first date, while others prefer to wait and see whether the relationship develops before disclosing.
Ms Daka said despite the fact that most people know about safer sex and how the virus is transmitted, fear and stigma can stir up very strong emotions and revealing one’s status may deter some partners from proceeding further in a relationship.
“Partners are hiding their ARV treatment in homes and in some cases, the keep the ARVs in their office lockers without their partner’s knowledge. It is only fair that one discloses their HIV status before they marry than come to put the blame on their partner in future even when they were fully aware of their status,” Ms Daka said.
It said it is also important to know that not everyone who has the HIV virus got it through sexual contact.
“We have unfortunate circumstances, such as those who contracted it from their mothers through birth, while others were defiled and raped either in their childhood or their adult life,” she explained.
A psychosocial counsellor working with adolescents said it is unfortunate to see older men going after young girls due to early marriages and also just dating the younger girls.
The counsellor, who sought anonymity, said a good number of young girls married in peri-urban areas have tested positive for HIV during their first antenatal visits and are fully aware that they have contracted the virus from their husbands.
“Their families are distraught about their partners’ lack of concern, but there is little they can do. It is unfortunate to see parents realise the importance of the girls’ education which is shattered through early marriage,” the counsellor said.
She said the challenge in testing for HIV is more with men as the often tested “by proxy”, believing their wives or partners HIV test results to be indicative of their status.
“We still have people who think they cannot be positive when their partner is negative and that is why there is need for continuous education about discordant couples, something we frequently witness,” she said.
This case and that of the reader who sent an email is not the only case.
There are many such instances across the country that are highlighting the urgent need for marriage counselors to encourage those entering into marriage to disclose their HIV status.
Ms Daka encouraged more men to go for testing with their partners and not leave it to the women who attend antenatal and family planning clinics as evident that a large proportion of HIV infection occurs in marital or cohabiting relationships.
Health experts have also observed that couple HIV testing has been recognised as being critical to increased uptake of HIV testing; facilitating disclosure of HIV status to marital partners; improving access to treatment, care and support; and, promoting safe sex.
The World Health Organisation (WHO) established a working group on engaging men into HIV care and at the 2018 International AIDS Conference, the US President’s Emergency Plan for AIDS Relief (PEPFAR), launched a global coalition to increase testing and access for men.
A community volunteer in tuberculosis and HIV/AIDS programmes noted how HIV testing is not a condition for receiving a marriage certificate, but with the privacy and confidentially that health workers have exhibited, it is only fair to disclose your status to your partner.
Febby Chisala said what partners are concerned about is the cancellation of marriage plans that can lead to suspicions that one of the prospective partners has tested positive.
She said disclosure may come with some challenges, but ultimately, not infecting your partner is what should be paramount.
Therefore, we need to encourage each other that stigma only has power when we give into it and as relationship experts observe, the reaction of your date or partner does not serve as the reaction of everyone that you will ever disclose to.
There is always someone out there who is going to love your honesty and find your transparency quite attractive.
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