Spouses secretly taking ARVs

A patient taking a drug regime.

MATILDA GOMO (not her real name) got the shock of her life when frantically looking for a spare tyre in the trunk of the family car used by her husband during his absence one afternoon, (he had gone out for a drink with his buddies), she saw a hidden stash of anti-retroviral (ARV) drugs under the tyre.

Upon interrogating her husband of nine years later that night, in a gruelling ordeal where at first he denied any knowledge of the stash, and then later gave in to her teary and accusatory inquiry, the 36-year-old housewife was able to finally draw out a confession from him. Her husband had tested HIV-positive two years earlier and about a year later had gone on anti-retroviral therapy (ART). While she acknowledged that her husband had lost a bit of weight over the years and that he had had two bouts of “malaria” in the subsequent year, Matilda had not thought further about it.

Packet from pocket
Elsewhere, another woman, Senzeni Mbanga (not her real name) was taken aback when doing the family’s laundry one weekend, from an inside pocket of her husband’s jacket fell a packet with different types of drugs which she made out to be ARVs.  It has been more than eight months since this incident occurred in the Mbanga household, but to this day the husband denies any knowledge of the drugs. Senzeni, 41, has been trying to get her husband to go and test for HIV since then but to no avail.

She herself has gone for testing and has tested positive, although her doctor has not yet prescribed ART. As she battles with the reality of her status, Senzeni also has to deal with the anguish brought on by her husband’s stance which means his status remains unknown, at least to her. Needless to point out relations between the two have been strained.

Eurita Ndongwe (not her real name) did not have the opportunity to stew in anguish or go through teary inquiries as in Senzeni and Matilda’s cases. She only learnt at her husband’s death bed, that even though he had kept quiet for the two years they had been married, he had known his HIV positive status and never told her.

“I was gutted and the state he was in as he lay there dying, was not one I could unleash my disappointment, anger and wrath at,” Eurita, 27, says. “And to think that for two solid years he never said a word.”

Cruelty not love
Yet life must go on, even with such unimaginable pain. “For someone to do that to his wife, it means there is no love in that marriage,” says Lucia Gunguwo, popularly known as Mai Gunguwo, of the Eternal Word Ministries who, although she offers other teachings, has found local fame over her ministering on issues of relationships, sex and the bedroom for couples.

“That is true lack of love. If you love someone you can’t be that cruel. When things get to that stage of not disclosing that you are taking ARVs to your spouse then that is not love. That is cruelty,” Mai Gunguwo says. While it is mostly men who do not disclose their status to their spouses, there are, however, instances where some women have kept their HIV test results a secret.

Recently media reports revealed that some women were not disclosing their HIV statuses to spouses in fear of breaking their marriages. Southern African Aids Trust country director, Roselyne Dete told a media workshop in Masvingo recently that the situation of non disclosure by women had given rise to the women not being able to adhere to their treatment, resulting in children being exposed and infected with HIV during pregnancy. “There are also issues of re-infection. When a spouse does not disclose, this impacts further on the couple as re-infection is likely to occur,” Mai Gunguwo said.

Power dynamics
“The power dynamics in the marital homes are the reasons why (there is no disclosure),why many children are being born with HIV and why some women (and men) are not adhering to treatment,” Dete said. Factors associated with non-disclosure, experts say, are gendered, where women who perceive greater HIV/AIDS stigma and are HIV positive are less likely to disclose HIV status to a spouse, and men who are worried about HIV infection from extramarital partners are less likely to disclose their HIV status to a spouse.

Bringing the virus home
Also impounding the situation of HIV testing in relationships is the issue of discordant results — where in a couple one may test positive and the other negative. That has often times led to spouses or partners who test negative pointing accusatory fingers to those who test positive. Experts say it does not always follow that the one who tested positive “brought the virus home”.  Scientists say HIV discordance is related to a combination of factors that include genetics, HI-virus type, the extent to which the infection has progressed in the HIV-positive partner, other sexually transmitted diseases and circumcision — which research indicates may reduce the risk of HIV infection.

Virus not systematic
“The virus is not systematically transmitted at each and every sexual encounter and depends on how far the HIV-positive person is in the progression of his condition,” Zimbabwe-based Dr Alexander Boon of the Spanish chapter of the NGO Doctors Without Borders was quoted as saying. Meanwhile, a peer review journal on HIV and AIDS from East Africa advises that systematic efforts to identify HIV-infected members and HIV-discordant couples in households of individuals taking ART could reduce HIV transmission and improve ART adherence as a holistic measure societies and nations can take.

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