Darling, let's get tested

Suggesting to your spouse that you go for a HIV test could rouse suspicion and mistrust, but this crucial issue need not be shrouded in mystery. SHIRLEY GENGA explores

In marriage, there are some issues so sensitive that raising them is like touching a raw nerve and broaching them takes tact and good timing.

Suggesting to your partner that you go for a HIV test is one such issue.

Experts say that it is extremely important for couple to get tested as frequently as possible, now that marriage is the new hotbed for infection.

According to the latest statistics, 44 per cent of new infections in Kenya are in marriage.

So how does one tackle the subject without raising suspicion or mistrust?

Janet* a businesswoman found out that she was HIV-positive when she was just about to give birth to her second child. To make matters worse, she was in an unhappy marriage.

Secretly got tested

"My husband would sleep with so many women, from the househelp to his colleagues at work. I knew about it because he never cared to be discreet. He was a drunk who spent his days in the bar, and always came home in the wee hours of the morning. On many occasions, I tried to insist that we use condoms, but he refused. When I suggested we go for a HIV test he would always hit the roof, asking if I doubted myself."

Janet says that she secretly got tested and the results were negative. She continued to get intimate with her husband without protection. It was not until three years later that she got pregnant with her third child and found out that she was HIV positive.

Says she: "I informed my husband and he packed up his things and moved out. He refused to get tested, claiming that it was I who had brought the virus into our marriage. I was depressed for a while but my mother encouraged me to fight for my baby.

Necessary precautions

My family was supportive and I took the necessary precautions and my baby turned out negative."

Janet now wishes she had been more assertive, saying it is the right of both parties in a marriage to know each others’ status.

How practical is it for a couple to go for regular tests? It is one thing to demand that a cheating spouse gets tested and an entirely different thing to ask a faithful spouse to go for a test. Unless the couple makes that an imperative routine in their marriage, and discusses it before marriage, it will cause friction.

When it comes to HIV testing, James Maina is one resolute man. He believes that spouses must know each other’s status always.

James married his wife in 2001 after finishing university. But later that year, something drastically changed their lives.

He narrates: "My wife and I got married in June, 2001. Later that year, she began to get some rashes but she assumed it was as a result of family planning method she was using, the coil. When the rush persisted she went to see a doctor who advised her to do a HIV test. The test showed that she was positive. Upon finding out her status she asked me to accompany her to the hospital. At the time, I did not even think anything was wrong. When we got to the doctor’s office, he walked out a little to talk to someone. Something prompted me to look at my wife’s file and so by the time the doctor came in I knew that my wife was HIV-positive. I was so shocked. It’s the kind of thing that we mistakenly think happens to other people."

When he was tested, the results showed that he was also infected. The couple decided not to play the blame game because each of them had had partners before so they decided to focus on taking care of each other.

"My wife and I had always been close so we talked about it and decided to stick together. I’m also grateful to our doctor because he helped as realise that it was not a death sentence that the important thing was that we both knew our status and know we could work around it. In October 2004, we had a healthy baby girl, but the following year my wife became very ill and after a long fight she died. It was a painful and traumatising time for me," says James.

Although the wife lost the battle, James is grateful that they got tested together, because it enabled them to take the right precautions and get a HIV-negative child. He also strongly believes that finding out his status ten years ago is the reason that he is still alive today.

He is a businessman and also works at Stacy Care Foundation, an organisation set up by Stacy Wakesho to offer infected persons a support group.

Regular testing

"We sometimes get women or men who have found out their status but do not know how to tell their spouses. While single people usually come looking for partners, married ones are just looking for a place to exhale because they find it difficult to tell their spouses. The organisation tries and counsells them on the importance of sharing one’s status with their spouse. Your spouse may be crushed, especially if you got the virus through unprotected casual sex, but he or she will thank you for it later."

Even for those not married, he advises that couples test together.

Says he: "Today 80 per cent of new infections are from people in very stable heterosexual relationships. When you know your status you can better protect the ones you love."

The National Aids/STDs Control Programme (Nascop) head, Dr Nicholas Muraguri, believes that it is important for married couples to go for regular testing.

"With 44 per cent of the new HIV infections occuring in marriages or with people who are in a ‘come we stay’ relationship, couples must test together regularly. Also, 77 per cent of Kenyans do not know their HIV status, and that is a major risk."

He advises that before getting into a relationship, couples should go for HIV testing together.

There are discordant couples (where one is positive and the other is negative), so it is not very effective if only one partner goes for the test; both need to go.

The doctor says that ideally a couple should go for annual testing but if one partner is unfaithful they should test more frequently or if one has picked a STD infection.

Pointing out that broaching the HIV subject is a tricky affair, he emphasises that the trick is that married couples should learn to communicate with each other frequently and to be able to talk about HIV freely.

"Communication is key. HIV testing is a topic that can be brought up during wedding anniversaries, birthdays, Valentine’s Day, or among the New Year resolutions. People should not shy away from this because it is a matter of life and death,"he adds.

At the end of the day, the medic stresses that everyone has a right to protect themselves and know his or her partner’s status.