A question I see popping more and more on social media, blogs and even on the streets with mixed reactions as the issue of HIV/AIDS is still a talking point even in the modern world thirty years later after its initial discovery and its renaming from the stigma infused GRID - Gay-related immune deficiency in the eighties we now however have strangely high rates of infection among men who have sex with men in particular, over 30%. Despite major improvements in social marketing with the requisite paraphernalia, ready access to information, rapid testing & counselling, wonderful antiretroviral and highly active antiretroviral therpy (HAART), improved condoms and an option to use the female condom (formerly FEMIDOM 1 now FEMIDOM II) and talk is that newer technologies are on the way we still ended up with an infection rate of over 30% in Jamaica in 2007 and as we await the official results of another survey done in 2011 all indications point to an increase in that figure.
My answer is yes as it is not about the HIV status of the individual that counts firstly although it will be important as to how we move on in the longterm but the whole person among other things .......... firstly let us look at some other pointers:
Serodiscordancy (couples with mixed HIV status) is a subject not often discussed locally as relationship issues generally in same gender loving couples are not looked at with any seriousness either by advocates or groups representing Jamaican LGBT people or I doubt if there are any studies done to look at the pyscho-social issues surrounding this phenomenon, so the bashing is allowed to continue and stigmatization occurs once it is even suspected an individual may have HIV, serodiscordant means by the way or (sero-discordancy) is a term used to describe a couple in which one partner is HIV positive and the other is HIV negative. Serodiscordant relationships are also referred to as "magnetic". The term seroconcordant is its antonym, used to describe a couple in which both partners are of the same HIV status (i.e. both are HIV positive or both are HIV negative).
A US HIV prevention study in 2009 supports what many researchers, activists and people living with the virus have believed for years--antiretroviral medications reduce HIV transmission in straight serodiscordant couples (where one person is HIV positive and one person is HIV negative) by 96 percent. Most couples of mixed HIV status face similar issues regardless of sexual orientation. Straight or gay, mixed couples usually live with fears about HIV transmission to the negative partner and concerns about maintaining a safe but satisfying sex life. Some encounter a profound lack of support and validation from family and friends, who often question why they're getting into or continuing a relationship full of risks like HIV transmission, illness, dependency and death. Of course, illness, death and dependency can happen in any relationship, but somehow HIV makes them more palpable. Serodiscordant couples face numerous issues not faced by seroconcordant couples, including facing a decision as to what level of sexual activity is comfortable for them, knowing that practising safer sex reduces but does not eliminate the risk of transmission to the HIV negative partner. There are also potential psychological issues arising out of taking care of a sick partner, and survivor guilt. Financial strains may also be more accentuated as one partner becomes ill and potentially less able or unable to work.
Research involving serodiscordant couples has offered insights into how the virus is passed and how individuals who are HIV positive may be able to reduce the risk of passing the virus to their partner. With PrEP being pushed now as prevention for HIV in negative persons how will this change the scheme of things once it is approved and becomes the norm worldwide providing that costs for ARVs and related medicines come to a reasonable price for nearly all to have access. Will this improve dating and hence long term relationships and literally remove some of the concerns serodiscordant couples face navigating love and their union?
Disclosure
Disclosure however of ones HIV status is still a major taboo issue judging by interactions on the subject when it is mentioned, when some enlightened gay Jamaican in particular decides to use a medium such as Facebook to point out quite openly their status as positive they are met with unbelievable hostility for the most part and are driven out of groups in some cases as has been noted in several MSM membered ones and even to the point of closure with tersely worded comments thrown at the nominee as a germ carrier and they are to just go and die, clearly we have long ways to go on this matter with this younger generation. Is there however some denial in all that backlash towards persons who are open about their HIV status or are persons out there knowing that they are HIV positive but are pretending to be otherwise so as to avoid the very stigma that they themselves end up serving on others who are open about the subject?
Similarly we are told and to some extent seen proof as well of homophobes who are in fact homosexual but use homo-negativity to cover their tracks or seek some sort of psychological relief from the guilt they feel of having same sex urges.
Overly Cautious
In any serodiscordant relationship, there is concern at the prospect of spreading the HIV infection to the negative partner. Sexually, the couple may become overly cautious and at the worst, stop any sexual or intimate contact in fear of spreading the infection. While it’s not the most important part a relationship, sexual intimacy is a key component of any loving relationship. Without intimacy, feelings of frustration, longing, and resentment surface and in turn, the relationship suffers.
Survivor’s Guilt
Guilt can be a powerful and destructive emotion. Most often, survivor’s guilt is a product of situations such as car accidents in which one person survives while many others die. The survivor feels guilty for having lived. In a serodiscordant relationship, the negative partner can feel guilty for being negative. The guilt increases if the positive partner becomes sick due to their HIV. In extreme cases of guilt, the negative partner wishes they too were infected, feeling their infection would relieve the guilt and other stressors present in the relationship. Stress itself can be a barrier to a successful relationship. But certain circumstances that arise in serodiscordant relationships that are particularly difficult.
Super-infection possibilities
HIV superinfection, which occurs when a previously infected individual acquires a new distinct HIV strain, has been described in a number of populations. SEROCONCORDANT couples (both partners being HIV positive) have this issue, the link here is that serodiscordant status may change in some instances as the negative partner's status may change for whatever reason and they may just continue the relationship as before but with new circumstances surrounding the union. Seroconcordant people can still exchange diseases other than HIV - Unprotected sex between two HIV+ people is not free of risk. Infection with one strain of HIV does not preclude later infection with another. There is a great deal of genetic variability within individual HIV populations and this variability is shuffled and mutated every time the virus reproduces inside a cell in the body. There are millions of viruses in the body of an infected person. Modern drug cocktails keep virus and mutation levels low but eventually drug resistance will develop. Unprotected sex between two HIV+ individuals does risk that one with a less aggressive, drug susceptible strain of the virus who might have kept his infection well under the control of the available drugs, might find him or herself with an aggressively drug resistant strain. Furthermore, dual infection has been associated with more rapid progression to AIDS
On dating a positive person
Even if the individual is physically showing early signs of opportunistic infections due to their impaired immune system I would date them if they are an interesting character, that's how far I would go and have gone in fact but more serious fallout may happen depending on how far impaired their systems have become or viral load counts as well which may make the dating process problematic publicly speaking such as a serious cold, cough or other more pronounced visible issues for example may make the dating process rocky, one has to be real in these matters but I guess it comes with years of engaging positive persons through other NGOs and the Ministry of Health's health promotions programs that has led me to this point. PLWHA - persons living with HIV need companionship too probably more so than negative ones as hinted above the issue of stigmatization is still a concern even from the LGBT community itself being persons who are out or not. It's about the personality of the individual, what they bring to the table, maturity, compromise, of course for me their proof of diligence in handling any health eventualities or complications from an impaired immune system and the matter of adherence to treatment is also crucial.
Their willingness to listen and to be helped while not feeling a sense of being "sorried for" by their partner is also crucial, I have seen generally persons rejecting assistance from others as they felt they were being pitied by the concerned party.
Of course if we decide to have a long term romantic union we would have to seek some sort of proffessional assistance in terms of navigating the possible stress issues, possible PrEP as prevention (for the negative partner as an option), treatment adherence for the positive partner, safer sex practices for both of us, maintaining faithfulness, conflict resolution skills and other related matters.
Certainly it is easy writing about it than living it but let us raise the profile about this issue.
Peace and tolerance
H