Sexual health rights of HIV sero-discordant couples
Denying sexual and reproductive health services to people living with HIV (PLHIV) or HIV sero-discordant couples increases their vulnerability to sexually transmitted infections (STIs) and makes it harder for women to protect themselves against sexual violence and unwanted pregnancies. At the 3rd Stop TB Partners' Forum, this 
"For the last few years I have been falling ill with different illnesses. In 2005, I went with my wife for HIV testing. She explained she wasn't going to divorce me if I tested positive. She just wanted to know what was making me sick" saidChrispin Siang'ombwa from Community Initiative for Tuberculosis, HIV/AIDS and Malaria (CITAM) in Zambia, who was also a member of the on-site HDN Key Correspondent team at the 3rd Stop TB Partners' Forum in Rio de Janeiro, Brazil (23-25 March 2009).
"I tested HIV positive and she tested negative. The first thing she did was to hug me" shares Chrispin.
"Before I tested positive for HIV, I had tuberculosis (TB) three times in 1995, and TB relapses in 1997 and 2004" says Chrispin.
"As TB is curable I continued to work in a meat processing industry's sales and marketing division. However because of my illnesses, I lost my job in 2004. I felt so frustrated and when I was leaving I told my General Manager that it is better that I go home and die at home as no one cares about my health in my workplace" recollects Chrispin.
"My wife was so touched, and supportive. Later my wife was invited to a workshop related to HIV and when she came back she related my illness to HIV. She counseled me and I hope people can imagine how one feels on getting counseling by one's own wife. She said she is not saying that I have HIV but she is helping me to take care of my health and both of us need to find a solution - she don't want me to be sick or to die and they have a long life to live together. I developed a fear that as she already knows her HIV status (negative) and if my status comes out positive then I was afraid of thinking the outcome" said Chrispin.
"One day I told her that I am afraid that if I test positive for HIV, she may go for divorce. She counseled me and said she wants to take care of my health. She took me to a hospital and we took the test" shares Chrispin.
Chrispin and his wife were asked to come to the hospital after three days to collect their reports.
"We didn't go to pick up the test results for five days and finally I was counseled if I was ready to take the result. At the end of counseling the counselor posed a question to my wife on her response to a situation if wife's result is HIV negative and husband's result is HIV positive. She said whether the result is HIV positive or negative, he is my husband. I was also asked a similar question and I too responded in the same way. We were given the envelopes and we opened our own envelopes. I was HIV positive and she was HIV negative. She hugged me and sat down with me for a while. She said that she loves her husband and don't want him to die. She said she will encourage him to take care of his health and go for the treatment. She continued loving me" says Chrispin.
"The counselor said that we are a very unique couple - and she was earlier counseling a different couple in a similar situation (HIV sero-discordant couple), but they were fighting and blaming... instead my wife was so supportive, understanding and loving" said Chrispin.
"Anti-retroviral therapy (ART) clinics in Lusaka (Zambia) were very few in those times, so we selected a clinic which was very far from my community because I was afraid of people from my community seeing me going to an ART clinic" says Chrispin. He began taking ART in January 2006.
"At every clinic visit, my wife was with me. My wife never lost hope and she was there on my side. I withdrew myself from the community, and I wasn't seeing anyone. Now I understand the high-levels of HIV-related stigma I was confronted with, particularly self-stigma" says Chrispin.
One day on a TV, I saw a news about a conference on HIV/AIDS being organized in Lusaka. I thought I need to attend this conference. When I went there the conference registration was already closed but one lady directed me to a room where people living with HIV (PLHIV) were meeting" shares Chrispin.
"This room was fully packed - later I understood this is where I belong. I came to know about Treatment Advocacy & Literacy Campaign (TALC). Later I discussed forming support groups for PLHIV with my wife, and a lady from our local church helped me come up with a list of six members who were in a similar situation" says Chrispin.
"Later at TALC, a journalist came from local radio and TV station to interview four PLHIV on stigma and discrimination and I was one of the four selected. Many months passed by and I had nearly forgotten about this interview" says Chrispin.
"This programme was aired. My four children were told by their friends that your daddy is on TV and my children went to the neighbourhood and saw the TV show where I was revealing my HIV status. My children's friends said they are sorry to hear that their father is HIV positive" shares Chrispin.
"My children later said to me that they also have a right to be consulted before my going public about HIV status" says Chrispin.
Chrispin and his wife have four lovely children.
"I sat down with my children to have a discussion later that evening. My eldest son said that he wasn't aware of my HIV status and they are worried about my health. He was concerned about my health and my going public regarding my HIV status without consulting my own children. I was too touched. I apologized to my children and said that peer influence led me to do this on TV, and pleaded forgiveness if possible. Children said that they love me as their father just as before, and my going public will help them in schools as they will get information" shares Chrispin.
"My eldest son went for HIV test to support me, and get more information related to HIV. My youngest son is in grade 6, and found some information about HIV from school, and brought it back to me" shares Chrispin the inspiring story of a family united together in Zambia.
Chrispin always consistently uses condoms in every sexual act with his wife, because they love each other and want to take good care of each other. "Condoms are always available in our bedroom, we take care of ourselves of using condoms and have protected sex always - because we truly love each other and want to take care of each other and our children" says Chrispin.
Many health providers assume that people with HIV or HIV sero-discordant couples do not have sex and fail to provide them with the information they need to prevent further transmission. The healthcare services to meet sexual and reproductive healthcare needs of PLHIV and sero-discordant couples need to be available as well.
Chrispin's experiences from his own life on how they as a family are unitedly dealing with HIV and tuberculosis are undoubtedly an inspiring testimony of how affected communities can demonstrate leadership in coming up with best solutions to their own problems.
Health-care workers need to recognise the specific sexual and reproductive needs of PLHIV in order to help them protect their own health and the health of their families.
- Bobby Ramakant
