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Let’s Talk About Aids, Baby

Updated on July 23, 2010

HIV Ribbon

We know the statistics, and we are confronted with the reality of HIV/Aids every day. And certainly, many modern women know how to negotiate condom use in the early stages of courtship. When it comes to long-term relationships such as marriage, though, things get very tricky. How do you tell your husband of many years that perhaps it is time to start using condoms?

It's a real challenge, because once you get married, condoms are past tense and the issue of trust comes into play. Most married women do not even know how to broach the issue with their spouses. 

According to studies, wives perceive themselves to be at much higher risk of contracting HIV than their husbands. Husbands' perception of risk is more likely to be dominated by their own sexual behavior, while wives' risks are more governed by perceptions of their spouse's sexual behavior, research shows.

A big part of the problem is that many couples do not go for testing together, if at all. Most women discover they are positive at the antenatal clinic. When they inform their husbands about their status, the husband assumes he is positive, too. This is wrong because he might actually be negative.

Additionally, when one partner is positive, they will most likely not reveal it to the other. People living with HIV find it hard to disclose their status for fear of rejection and judgment by society. Most people still equate HIV with promiscuity and for many, the worst thing that can happen is having others find out about their HIV infection.

Couple discordance (discordance is a term used to describe a situation where one partner has HIV and the other does not) is a major challenge in the world today, because the negative partner still runs the risk of becoming positive, and may re-infect their already positive partner. Moreover, many uninfected partners tend to walk away later in the relationship, not wanting to be tied to a "sick" partner.

Although couples now find it easier to get tested before tying the knot, lack of consistency in their sexual behavior through marriage still worries many HIV experts.

Current data on new infections suggests that the incidence of HIV is rising among married women worldwide. Couples' diagnostic testing and counseling services are helpful to couples who would like to talk openly about sexual health.

However until microbicides - still in developmental stage - are widely popular and readily available, women will not have true bargaining power in the bedroom. Unlike male or female condoms, microbicides are a potential preventative option that women can easily control and do not require the co-operation, consent or even knowledge of the partner.


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