On a hot sunny Wednesday afternoon a couple walked into a VCT site in Rongai to check on their HIV status.
Unbeknown to the HTC counselor they couple already knew their status and had
only come for a reconfirmation. The HTC counselor proceeded with counseling them
as required by the national HTC guidelines. She took them through all the recommended
procedure after which the couple gave their consent to be tested.
Both the first and second test confirmed that the couples were discordant. She proceeded to further counsel
them on the implications of discordance but the man cut her short and told her
that they had only come to retest themselves after several test had shown the
same results. They had previously done five tests which all showed the same results, something that had made the wife
to become suicidal because she is the one who was sero-positive.
“Sasa mimi nimekwisha nasitoki hapa nikiwa hai,” she cried “Dakitari nipatieni dawa nikunywe nikufe nikiwa
hapa.” (I am now finished and I’m not leaving this place alive. Doctor, give me some medicine that will kill me.)
The HTC Counselor referred them to her supervisor who was more conversant with discordant counseling. They moved to
another room in the facility which accorded them more privacy. During the session it emerged that it was not the first time the wife had been suicidal. Apparently, she had tried to kill herself by
taking rat poison that weekend and her husband rushed her to hospital for first aid. She said she was hungry as she had not eaten since that fateful day. She was given food which initially belonged
to the second HTC counselor and she threw it on the floor. Her husband took what remained of the food and he tried to feed her but when she refused he ate
it all up, after all she wanted to die.
Crying and screaming the woman claimed that her husband didn’t love her because he wanted to take a second wife.
The husband affirmed this and said it was because he wanted to have children.
“Sitamutupa nitampleka oshago kwa mathe kwa sababu yeye sasa hawezi kunizalia watoto.” (“I won’t dump her I’ll
just take her to my mother’s place in the rural area because she cannot give me children with her condition.) He defended himself.
“Si unaona hiyo matharau, nimeishi nayeye miaka tatu na sasa kwasababu nina ukimwi anataka kuniwacha.
Sasa tunakufa hapa. Mimi naenda lakini yeye ndiye ataenda kwanza” (“ I have lived with him for three years and now he wants to live me because I have AIDS,
we shall die here, I will go but he is going first.)
She started screaming in kikuyu language and hitting her husband. She then removed her sim card from her phone
crashed it and gave the phone to her husband. She became uncontrollable all the while claiming that she was going to kill both her husband and herself. When no
one could restrain her the counselors sought help from the local police station in who came to arrest her because of the threats and chaos she was causing.
She wanted to however beat the police officers when they arrived but eventually they overpowered her and took her away to cool off.
HIV discordant couples face many unique challenges in maintaining stable relationships especially when the woman
is found to be sero positive or infected with the HIV virus while the man is not. Discordance has seen the dissolution of many relationships because the men
most often do not understand or are afraid of being infected.
Has discordance been given the attention that it deserves?
A study funded by Bill and Melinda Gates with the aim of finding out whether Pre exposure prophylaxis
prevented HIV infection where one of the couple was HIV positive and the other HIV negative has shown that there could be hope after all for discordant couples.
The uninfected couple will be required to take a daily dose of ARVs in order to reduce the risk of HIV infection.
If approved the findings could make PrEP a major tool in the fight against HIV and AIDS and present discordant couples with a means to have children without
fear of infecting one’s spouse.
The lady in question was later released after spending a few hours in the cells and has since then stopped being suicidal after she got a promise from the husband that he would not take
another wife. They are now attending support group session for discordant couples.