Couples should aim to reduce HIV infections

Herald Opinion and Analysis

Although there are talks of breakthroughs in the research into possible HIV treatment, the bleak truth is that right now there is no cure for HIV. ARVs enhance the quality and length of life for the infected but with international donor funding drying up, the country cannot keep adding to the numbers of people who need treatment. The current situation where we have high infection rates is just untenable. With the infected needing ever improving services and support systems simply cannot afford to have the bill continue to increase. The continued high incidence rate of HIV infection within the marriage institution is a reflection of the prevailing attitude that getting married is a method of preventing infection. Nothing could be further from the truth. Last year statistics revealed that married women had the highest rate of HIV infection compared to any other demographic grouping. Results of a medical study linking high infection rates to the use of hormone-based contraceptives may just be the explanation for that phenomenon.

The condom is the most reliable method to prevent the spread of HIV after abstinence but it is not a secret that most men will not even think of using condoms with their wives or regular partners.There is a perception that it is only when one engages women of "loose morals" that the topic of condoms should come up as "decent" women are "clean". But HIV knows no principles and will not select to infect a person based on whether they have signed a marriage certificate or if their parents have received lobola.

It is this attitude that needs serious rethinking, especially on the part of men. All men would like to believe that their wives are paragons of virtue who would never cheat on them. Infidelity knows no gender. A look at the cases that are brought before the police and the courts any day will show that adultery by both sexes is the major driver of domestic violence and divorce.
This means that no one can afford to be complacent in any relationship. Each one of us has to stop thinking about HIV as a remote chance that has nothing to do with us until we fall ill or get tested and find out that we are positive. Everyone, male and female has to take responsibility to ensure that they themselves do not get infected, or if they are already infected, then they must make sure that they do not pass on the virus to anyone else.

Male circumcision has been found to reduce a man's chance of getting infected with the HIV virus by about 60 percent. But the hormone-based contraceptives are said to double the chances of a woman getting infected and passing on the virus. So even if a man is circumcised but his wife engages in an extramarital relationship with an infected partner then the chances of that husband catching HIV may still be unacceptably high and it is in his own best interest to protect himself.

There is no denying that the condom is not a very romantic addition to a relationship, but then again, neither is HIV.
Forty years ago even the idea of a married woman taking charge of the family's reproductive decisions by going on the pill or injection was anathema.
But over the decades a completely new mindset has emerged and now a man thinks it is a very stupid woman who is not on contraceptives of some kind and ends up with an unplanned pregnancy. The same

paradigm shift is needed on use of condoms in marriage.

For married couples living with HIV, whether they are both infected or it is one partner with the virus, condoms are a constant companion due to the risk of re-infection. So for married couples to just forego the condom before they are infected is not very clever.
It simply means that they will most probably end up using the condom later when one or both are infected. So if a couple is serious about keeping HIV at bay, the use of condoms on the marital bed has to be discussed before and not after infection.