HIV and AIDS - Discordant Couples

Discordant couples are those where one partner is HIV-infected and the other is not. A couple is defined as two persons in an ongoing sexual relationship and each of these persons is referred to as a “partner” in the relationship.

There are numerous risks for discordant couples, which require careful management and comprehensive psychosocial support. In April 2012, WHO released guidelines on “Guidance on couples HIV testing and counselling, including antiretroviral therapy (ART) for treatment and prevention in serodiscordant couples: Recommendations for a public health approach”, emphasising the importance of support to discordant couples.

Risks include

  • HIV Transmission – there is a risk of HIV transition to the negative partner. In the WHO guidelines it is recommended that positive persons in a discordant relationship should be started on ART, regardless of their CD4 count, in order to reduce HIV transmission to the uninfected partner.
  • Couples will need continuous counselling on condom use to ensure safer sex is always practiced.
  • Stigma – the community still finds it difficult to understand how such a relationship can prevail.
  • Myths – transmission of HIV is dependent on a number of conditions being fulfilled.  A lack of understanding of these conditions has led to myths and misconceptions around the disease. Discordant couples have often been at the centre of these myths, with belief that some people are immune to HIV.

Zoë-Life’s Role

Zoë-Life has capacitated health care workers within DoH, municipality and at a community level to implement strategies and interventions for discordant couples. These include:

  • Couple Counselling
  • Support groups
  • Dialogues/Talks/Debates
  • Information seminars
  • Community outreaches
  • Family planning