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Episode 5 - Sero discordant couples and prevention

Relationships are intricate things. Fraught with possible stresses and complexities. Add to the mix HIV and there is what some people may see as a near-impossible situation. But that doesn't have to be the case. With honesty, trust and respect a sero-discordant relationship can be even healthier than your average relationship!The fifth Episode of Siyayinqoba Beat It! discusses sero-discordant couples: where one partner is HIV negative and the other is HIV positive.

Shalom Ncala: SeSotho [Hello and welcome to Siyayinqoba Beat It! The only show for people living with HIV/AIDS, our partners, families, friends, colleagues, health workers and everyone in South Africa. Hello everybody. This week we are talking to couples who have HIV in their relationship. That means that one partner is living with HIV and the other is negative. This is called a sero discordant couple. Sounds complicated? Not really. Lots of people do it. Let's go meet a couple in Gauteng.]

Mxolisi Mgoboza: [Namhlanje sise Sebokeng zize ku Thabisile and James. Bazakusixelela nge sex life yabo omnye unegetive omnye upositive.] [IsiXhosa] Today we are in Sebokeng to see Thabisile and James. They're going to chat to us about their sex life. He's HIV negative and she is HIV positive.

Thabisile Dlamini: I found out I was HIV positive in 1999. Then I decided to join the TAC because I also wanted information. And I knew that it was going to help me and it was going to benefit me as an individual. In the group of TLPs in 2004 there was James. [ I found out I was HIV positive in 1999. Then I decided to join TAC (Treatment Action Campaign) because I also wanted information. I knew it was going to help me; that it was going to benefit me as an individual. In our group of TLPs (Treatment Literacy Practitioners) in 2004 there was James.]

James Dlamini: SeSotho[ She revealed her HIV status the very first time we met. We started out as friends. We used to have lunch and breakfast together. And she told me she wanted an HIV positive partner.]

Thabisile: [At that time I was thinking if ngingena kwi relationship definitely where I would settle nomuntu oyi one. Even if its not marriage but yi-relationship ozo laster for quite some time. So if it is someone who is HIV negative how am I going to relate to this person cause obviously angekhe ayi file lento engiyi felayo. He is HIV negative and I am HIV positive so its a huge difference.] (At the time I was thinking that if I get into a relationship, I have to settle with this one person. Even if it is not marriage, but a relationship that would last for some time. So if it is someone who is HIV negative, then how am I going to relate with this person? Because obviously he wouldn't know how I feel. He's HIV negative, I am HIV positive, and there is a huge difference.)

James: Seotho [People out there don't know what's happening. They expect us to have a baby. But we don't live our lives according to people's expectations. We will have a baby when we are ready, and when we have taken all the necessary precautionary measures. Lots of people get infected in marriage or in their relationships, because they don't know their partner's HIV status. I am lucky because I knew. She told me about her status and I accepted her. Its something that I can take cover from.]

Thabisile: [ My wish is that singahlukani because I don't i-life yami izaba difficult without James. I've come to uku rely kuwe for everything. So if ngingam losser angekhe nje ngisurviver.] [IsiZulu] My one wish is that I don't lose him because my life would be very difficult without James. I've come to rely on him for everything. If I were to lose him, I wouldn't survive.

Shalom: [Guys lento siqeda ukuyibona is very interesting because it's got me thinking indaba yokuthi umangabe umntu ezithola ukuba u positive kuyenzeka nakithi nakuwo wonke umuntu afune ukwenza lento yenziwe ngu Thabisile ukuthi ufune umntu o positive nawe na?] [IsiZulu] What is interesting is that Thabisile was looking for someone also HIV positive.

Nokubonga Yawa: [Ndazixelela into bana ndifuna umntu o HIV positive because yena uza ku understander.Ngelaxesha ndandingekho informed .i-HIV ndandingazi lukhulu ngayo. But then ndithe ukwazi kwam kabanzi nge HIV ndabona ukuba no akunyanzelekanga ukuba ndibe nomntu o HIV positive ngenxa yoba ndine gxala loba if ukubana lomntu ufuna ukunditshata umntwana nzaba naye njani izinto ezinjalo. Andisena gxala ngoku because ne boyfriend yam iHIV negative. So ke siyaqhubekeka nje kakuhle uyayazi ukuba ndi HIV positive ndityi pilisi zam uyafowuna noba andikho ecaleni kwakhe abuze baby uzityile ipilisi. So uyabona ukuba lamntu uHIv negative but uyayi understander into yokuba u baby wam uHIV positive so kufuneka ndim supporte kwinto yonke ayenzayo. ] (IsiXhosa) When I first tested HIV positive I wanted an HIV positive partner who would understand. At the time I was not informed. I didn't know much about HIV. But then after learning more about HI, I realized I was not forced to be with an HIV positive partner. As a result, my boyfriend I have now is HIV negative. He knows about my status, I take my ARVs, he even calls and asks if I've taken it. So even though he's HIV negative, he still supports me as an HIV positive person.

Luckyboy Mkhonzwane: [Mina kwicase yami, I never thought after ngi tole I status sam kuthi ngi HIV positive I would need ukuthi ngizwane specifically nomuntu who is HIV positive. Because I realised ukuthi I got infected like not knowing ukuthi my partner is HIV positive. So I don't see any differnce whetehr the person is HIV positive or the person is HIV negative. As long as I would be open about my status and sivumelane mina naye ukuthi we are getting into this together his going to understand. Since I discoved my status I have never been with anyone who is HIV positive. All my previous partners have been negative.][IsiZulu] In my case, after I knew I my HIV positive status, I would specifically need an HIV positive partner. Because I realized I got infected not knowing that my partner was HIV positive. And so I don't see any difference whether the person is HIV positive or the person is HIV negative. As long as I would be open about my status and we agree that we're getting into this together and he's going to understand. Since I have discovered my status I have never been with anyone who is HIV positive. All my previous partners have been negative.

Shalom: [Beku interesting lento uyishoyo because yabona when it comes kumina, mina ngangi angry kakhulu when I found out i-status. I thought ukuthi this is it angekhe ngisaphinde ngithande muntu akudingeki ngibe involve in relationships zi complicater yonke isituation engikuyo because fanele njalo ngi disclose ngizi explainer ndithathe ama steps ukuthi ngi mprotecter and staff. So bengi angry with the whole situation.] [IsiZulu] It's very interesting what's you're saying because for me when I found out about my status, I was very angry. I thought this is it, I'll never be in a relationship again. It only complicates the situation because I would have to disclose to them and protect them at the same time.

Busi MaqungoI didn't think kufuneka ndithi ndifuna umntu othe awuyi pleni, iyazenzekela nje ngokuno kwayo. But then am thinking into yokuba involved ungumntu o-HIV positive nomntu o-HIV negative inawo ama challenges awo maninzi kakhulu especially when it comes to stigma. Because okokuqala uza ku disclose kulomntu uzakufuna ukuba honest kuloo mntu udisclose ukuze nazane into yokuba wena uHIV positive. Zininzi like njengoko be nditshilo zikhona I challenges okokuqala lomntu lona anga baleka kwi cases ezininzi siyayazi ezo zinto ziyenzeka. Yo start disclosing emntwini akaphindi nje abuye, akaphinde afowune, udelita ka fowuni namba yakho efowunini yakhe. You get to wonder kwenzeka ntoni. [IsiXhosa] I don't think I plan to be with a negative or positive person, it just happens. But then I think if an HIV person is involved with an HIV negative person, there are lots of challenges, especially when it comes to stigma. Firstly you have to disclose to this person in order for you to know each other better. I most cases, after disclose, the partner tends to leave you. They delete your number and you are left wondering what's going on.

Fannie de Villers: I also think when at first you think okay fine, lets go for a positive partner. Why?, Why does one do that? Is it for support, is that person going through the same staff, would we be able to support each other road ahead. But sometimes also think do you put more stress on the relationship. Because now you're dealing with HIV in your own life but also you have to deal with HIV in your partners' life. So do you really get a break from just not being HIV positive?

Shalom: Being in a relationship where both of you are HIV positive it puts a strain on you and you can't be able to differentiate yourself from the situation as it stands, because its always about being HIV positive.

Fannie: Can one really choose who you fall in love with?

Shalom: I understand you can't but I must say after that relationship, my experience was that I didn't want to go and fall in love with someone who is HIV positive again.

Busi: [I think bukhona ubunyani kulento niyithethayo Fanie, Shalom ukuba xa ukwi relationship apho noba bini especially if anikho kwi stage esinye nalomntu. Omnye wenu mhlawumbne sele progresse kakhulu with HIV. Everytime something happens you get to think oh my God this is it. And it puts I pressure kengoku okanye istrain kulona omnye that could have i-negative impact empilweni as an HIV positive person .And you really don't need that.][IsiXhosa] I think I see what Fanie is Shalom. It is stressful when both partners are positive. Especially if one partner is at the worst stage of HIV. Every time something happens you get to think oh my God this is it. It puts a strain or pressure on the situation that could have a negative effect on your health as an HIV positive person. And you don't really need that.

Shalom: Then again Busi we are not saying ukuthi its wrong ukuthi uzwane nomuntu o positive xa upositive. What works for you won't necessarily work for me. This is just relationships nama dynamics azo. [IsiZulu] We're not saying it's wrong for two positive people to have a relationship. What works for you won't necessarily work for me. This is just relationships and their dynamics

Fannie: Just remember that one always runs the risks of contracting the virus. That is something that we need to realize, is that if you're in that relationship where one is positive and one is negative. The risk is always there and how are you going to deal with the situation if the other partner who was negative comes positive.?

Shalom: SeSotho [Don't go away. We'll be right back.]

Shalom: SeSotho [You are watching Siyayinqoba Beat It! Let's go to Mdantsane in the Eastern Cape and meet another couple where the one partner is living with HIV.]

Amanda Funani: [Sise Mdantsane si vizitele usis' Lungiswa ophila ne ntsolongwane kagawulayo. Sizskube sithethanaye ne boyfriend yakhe e HIV negative. Wamxelela nini ukuba upositive? [IsiXhosa] We are in Mdantsane visiting Lungiswa who is living with HIV. We'll be talking to her and her boyfriend who is HIV negative. When did you tell him that you are positive?

Lungiswa Mpofu: [Wayengasazi isi status sam. Ndingatsho mhlawumbi wayesazi wayehlala around apha, apha e areani. Abanye abantu babe mxelela but ke ndamxelela ngokwam ukuba andizolunga ukuba sithandane ngoba mna ndi HIV positive.][IsiXhosa] He didn't know my status. He lived around here and some people told him ,but I decided to tell him myself, that I am HIV positive.

Amanda: [Oh wamxelela kwangokuyana?][IsiXhosa] You told him when you first met?

Lungiswa: [Kwangelo xesha ngoba kaloku umntu uthi xa umxelela ngesi status sakho angaphinda abonakale. ][IsiXhosa] Yes I told him that time because most people after you tell them your status, they never come back.

Amanda: [Wawu ngoyiki ngokuyana wayekuxelela ukuba upositive?][IsiXhosa] Were you scared when she told you she is HIV positive?

Wright: [Ngcambu: Ndingaske nditsho ndandisoyika wena my sista esi sifo kuba ndisa soyika nangoku kodwa olona loyiko lwalu ngabantu basekhaya yaqonda. Bazakuthi ndingathini ukuthandana nomntu o positive nton-ntoni yonke lonto. Qha ke since yena unga lamntu uthetha phandle onengena ngxaki ngoba e-positive, waske wayithetha nje bhuhlu wayithetha nakudade wethu opha kwa 2.][IsiXhosa] I was afraid and still am, but I was most afraid of my family. They won't understand why I'm living with an HIV positive person. But since she is outspoken and has no issues about being HIV positive, she spoke to my sister about it.

Amanda: [Bazithatha njani ezondaba?][IsiXhosa] How did they take that news?

Wright: [Azange babe funny ngalonto][IsiXhosa] They were never funny about it

Amanda: [And then xa nithi nenze isex nenza kanjani ukugcina onmye e negative?][IsiXhosa] When having sex, what precautions do you take to keep him negative?

Lungiswa: [Ndamfundisa ndaqonda mandimnike ieducation azokukwazi ukuthi ayiqonde indaba ye HIV. Moss asikuphela kobomi xa uHIV positive ayiqonde. So ndamnika i-education yayi understand yayibona nendlela into engayo. So ke sisebenzisa icondom oko oko. Akanangxaki nam andikabinangxaki.] [IsiXhosa] I first taught him about HIV and that it's not the end of life. So I made him understand about it all and we use condoms all the time. We have no problems.

Amanda: [Xa usebenzisa icondom qho nisenza isex, ufelisha kanjani? I ngaba ufelisha ingathi uyindoda nah? ][IsiXhosa] When you have to use a condom every time you have sex, how do you feel? Do you feel like a man?

Wright: [Icondom yona iright for indoda iyisebenzise nomntu obinqileyo amkhuthaze u boyfriend yakhe okanye umyeni wakhe ukuba makasebenzise icondom ukunqanda ukosuleleka. So mna ndizifelisha ndiyindoda akhukho nto ifunny.] [IsiXhosa] A condom is good for a man to use. And the female should encourage her boyfriend or husband to use a condom to prevent infection. So I feel very much like a man. There is nothing strange about condoms.

Lungiswa: [Mna into endinokuba cebisa yona, into abalulekileyo xa uthandana nomntu oHIV positve unegative kubalulekile okokuqala wena mntu upositive discloser kulo unegative yi disclosele, nizokwazi uku negotiate indaba ye condom.] [IsiXhosa][ If you are in love with someone who is HIV positive and you're negative, it's important for the positive one to disclose to the negative partner, so that using condoms can be negotiated.

Shalom: SeSotho[ This story has a really interesting take on condom use and manliness. What do you think? Do most men feel this way?]

Luckyboy: Mina ngikholelwa ekuthini ukusebenzisa ama condom akukwehlisi ubudoda bakho. Ngoba noma kungenzakala ukuthi nikwi relationship ninoyo two nomuntu ne nobakwenzakale ni negative. Using icondom is the only way eninga zivikela ngayo. Because abanye abantu kuyenzakala uthi you are postive but akusazi istatus sakho but its a way of protecting yourself and also protecting your partner. And in my case in all the relationships endiye ndabakuwo ama partners am we okay with using ama condom, because I feel ukuthi I wouldn't be able ngiphile naleyo guilt leyo ukuthi ngiye nga infecter omunye umuntu. [IsiZulu] I believe using condoms does not make you less of a man. You have to use a condom whether you're positive or negative. Using a condom is the only way you can protect yourself, because even if you don't know your status, it's a way of protecting yourself and also protecting your partner. In all the relationships I've been in, my partner were OK with using a condom, I wouldn't be able to live my life knowing that I've infected someone else.

Simphiwe Mgongoshe: Bengisha uthi nam ndikwi favour yababantu bathi ama condom. Umasebenzisa ama condoms akutso ukuthi kuphela isidima sakho. Ukusebenzisa icondom kukuzibonakalisa ukuthi une care yomunye umuntu. So ke nam ke ngihambisana nabantu abathi kufuneka uzivikele uvikele nabanye abantu. Kodwa umasihlangabezana nezinkinga ezisemakhaya lapho kukhona obaba abasathi bona umasikhuluma nge culture yethu kukhona obaba abaye batsho bathi " Mina ndakulobola into zoba ndifake oplastic ama condom andihambisani nayo. So ke sisene nkinga yangephela phela ngezinto zase makhaya. Yinto ekufuneka siyisukumele ukuthi abantu abasemakhaya bafundiseke kahle ngoku protecter yena aprotecter no partner wakhe.[isiZulu] I'm in favour of the use of condoms. Condoms don't destroy your dignity. Using condom show that you care about people's well being, and I agree with people who say protect yourself and protect others. But culturally, we still have a problem at home, especially the men who feels it's not in their culture so they are stubborn and don't want to use condoms. We should stand up and educate those people and protect themselves and protect their partners.

Busi: Am not sure but ezo zinto zenzeka kule case ndiqhiba kuthetha ngayo. Yoba aba bantu bazani kodwa xa bathe bazana into yokuba omnye ugcaphazelekile omnye akagcaphazelekanga then abafuni naloo wesibini abe uyachaphazeleka . Ayikhathaliseki into youkuba ndikulobole okanye andikulobolanga into ekuthethwa ngayo ngoku kukho lentsholongwane. And enye into endichinga ukuba abantu abajonga kuye ingakumbi abantu abatsha it's not only iHIV icondom eyikhuselayo. Sine unwanted teenage pregnancies sine STIs ezingezinye ngaphandle kwe HIV. So it gets to protect izinto ezininzi ngaphandle nje kwechiwane lengculaza. [IsiXhosa] I'm not sure, but like I said, that only happens when people feel they know each other. Then only when one is positive and the other is negative, they use protection regardless of culture because there is a disease involve. What I think people should know, especially the young people, is that it's not only HIV that condoms protect against. It prevents unwanted teenage pregnancies, as well as STIs other than HIV. So it protects against a lot of other things.

Simphiwe: Busi ngiyayizwa kakhle. Kukhona obaba abasebenza ema Township umuntu, agoduke uma kuphela inyanga. Umasevika la kunkosikazi wakhe icondom akakhulumi ngayo. Abe yena mhlawumbi kukhona izinto ebezenza. La kuma urban areas athole iHIV kumagege amancane. Kutsho lapho unkosikazi wakhe osemakhaya uzothula yena uzamthelela njalo. [IsiZulu] Busi, I understand you completely. There are men who work out of town and only go home once a month. When they return home to wife, they don't use dondoms. There's a possibility that they man could've been misbehaving. There could be a possibility that he may have contracted HIV while he was away. He could have contracted HIV while he was away and then infected his wife.

Busi: But do you think that has a lot to do with into yokwenza noba lomntu ezakulala nalomntu kuba iyinkosikazi yakhe enganaku sebenzisa icondom okanye inento yokwenza nalento yoba ezakuthi xa esebenzisa icondom abengathi akayo ndoda ngokwaneleyo okanye ngokupheleleyo? [isiXhosa] Does it have to do with them using a condom because she is his wife? Does him using a condom, puts his manhood into question?

Simphiwe: Ngicabanga ukuthi mina ukuthi uzakucabanga ngolohlobo lobana akayondoda ngokupheleleyo. Nokuthi at the same time angafuni ukuthi aphumele lubala ukuthi ngoyena oze ne HIV ekhaya. Inginga ezinjalo nje.[IsiZulu] I would say he would think that, that he is not man enough. But at the same time he doesn't want it to be known that he contracted HIV. Problems like that.

Busi: I think la mfana uchaphazele enye yezinto ezibalulekileyo that yena wayengena ngxaki yedwa o-involved kukho abazali, netshomi nabanye abantu the community nabo babukele kulento lena. And people turn intobana ukwi relationship nomntu oHIV positive and o-open njenge girlfriend le ebethetha ngayo bagcinge ukubana automatically nawe uHIV. Those are the things esihlangabezane naza xa sithi sibe involved with abantu aba HIV negative thina bantu ba HIV positive. [IsiXhosa] I think the guy from the previous insert pointed out something important. He didn't have a problem with his HIV positive girlfriend, he was not the only one involved. There's the parents, friends, the community, and they are watching. People think you're HIV positive when you're involved with a positive person. Those are the things we face when we're involve with negative people.

Shalom: SeSotho [Stay where you are. We'll be back.]

Shalom: SeSotho [Welcome back to Siyayinqoba Beat It! Let's watch this story from the Western Cape about a well known figure in HIV in South Africa.]

Zackie Achmat: Today am getting married. Am becoming committed, I am marrying Dalli.

Dalli Weyers: Not too nerve recking but I know am anxious. Just a bit nervous. Afrikaans [Mom, you look pretty]

Dalli's mom: Am happy as long as my son is happy am happy

Dalli: The main reasons to want to have a wedding and a ceremony and a reception was so we could celebrate the day with our friends and family.

Zackie: I hope we will be bride groom and bride groom of the year.

Edwin Cameron: So we rejoice that you have chosen to do this out loud and in our presence. Out of your wish for us to be part of your decision and so to reinforce it and to affirm it for you.

Dalli: I will go first I do

Zackie: I do too.

Edwin: Would you place the ring on each other's hands? The marriage certificate ladies and gentleman.

Dalli: I can say until death do us part but I won't... those vows are for optimistic couples. The once full of hope and I do not stand here om my wedding day optimistic or full of hope. Am not optimistic am not hopeful, I am sure, am steady and I know you're my partner, you are my lover, you are my very best friend.

Dalli: Me being the HIV negative one I know the science of condoms and I know that condoms work. And so I feel that as long as we condomize we're safe.

Zackie: The great thing is he knows his status and I know my status. And if that's the case it means that someone who is positive and someone who is negative can live together and protect each other.

Shalom: Guys lena yi classical example of how I oneness work. I think isijekisa kahle umangabe niyi two and you're getting into a relationship ikakhulu a sexual relationship be it long term or short term. Its important for umntu ukuthi azi ukuthi umephi in terms of istatus sakhe, be it positive or negative so that we can protect each other.[IsiZulu] This is a classic example of how openness in a relationship works. When two people get into a relationship, especially a sexual relationship, be it long term or short. It's important for a person to know their status, be it positive or negative, so that we can protect each other.

Luckyboy: Siyazi ukuthi through out the relationship lets say ngengoba usis Busi eshilo abanye abantu from ekuqaleni beqeda ukudiba nomntu whether uyasazi istatus sakho o awusazi nizosebenzisa amacondom. Kuyenzakala sometimes ukuthi icondom ibuster uyazwisisa, so ukuba open kuyanceda mhlawumbe mina ngi positive and then umlingane wam unegative. Kuyenzakala ukuthi sibe nalonkinga yokuba icondom idabuke siyakwazi ukuthi senze ama-measures lakufanele siwenze ukuthi umntu wam akwazi ukuyo accesser iPEP uyavisisisa ukuthi akwazi ikuvikela ukuthi angatheleleki ligciwane [IsiZulu] Most people, regardless whether you know your status or not, use condoms. It sometimes happen that the condom breaks, so it helps to be open about your status in those situations. So if the condom breaks, we can take measures to protect ourselves from contracting HIV.

Busi: Kule case ka Zackie no Dalli njengoko siyibona ukuba ingumzekelo omhle we sero discordant couples. Nangona bona bengamadoda bobabini, kungazukubakho xesha apho bazakuna ukwenza umntwana. But ke kwi relationships apho iba ngumfazi ne ndoda omnye unegative omnye upositive.Siyazazi ukuba mostly kwi relationships ezinjalo kufune kubekhona umntwana apho kuthe kwatshatwa khona. Kuba khona ingxaki ezithile abathi bahlangabezane nazo. Yenzeka njani kengoku into yokuba kuzakufuneka kubekho umntwana? [IsiXhosa] Zackie and Dalli are a good example of a sero discordant couple. Their case is different because they are both men. They won't have a problem with children. Hetrosexual sero discordant couples face problems when it comes to having kids. They encounter difficulties. How do they go about having children?

Fannie: Ja Busi I mean it's a absolute reality that sooner or later you would love to have children especially if you love children. And its something that can be dealt with, its something that can be dealt with quiet easily. We get this situations that one can wash the sperm. You have to get on medication first, ARV treatment get your viral load to undetectable. Because what we need to remember is that its not the sperm and the egg that's got the virus but its the semen and the vaginal fluid that's where the risk of infection comes in. For two positive people even two positive people if the woman becomes pregnant that baby will be negative for that full nine months. It's so possible for people to have children.

Shalom: SeSotho People who are living with HIV can still enjoy a great sex life. But there are some important things we have to remember. Get tested. Know your status. Being open with your partner is the first step to a happy relationship. These bangles show that we are protecting ourselves and protecting others. You can also protect yourself and protect others. We will be back same time, same place next week. Until then, protect yourself, protect others. Bye.