Breaking the Pattern: Couples’ HIV Testing

30 06 2010

In the past few weeks I have had the opportunity to observe some counseling sessions with HIV+ and potentially HIV+ patients.  The majority of the sessions I witness involve medical assistants here at CMS advising a young or middle-aged HIV+ woman on how often and what types of antiretroviral medication she should take.

Sometimes, however, the counseling sessions are for a husband and wife pair.  One day I watched a young couple come in for a session.  They seemed polite but slightly on edge.  The following conversation with the counselor was in Ewé, but another medical assistant related in French to me the main points.  The wife had come to the clinic to treat a viral infection.   In examining her, however, the clinic personnel had begun to suspect that she also could be HIV+.  The day of the counseling session, the wife had not yet taken the test but would soon.  Much of the session, though, focused on her husband’s response and actions.  The medical assistants tried to encourage the reluctant husband to take the HIV test together with his wife.  Often in Lomé, the wife will first learn that she is HIV+, and in response the husband will simply leave her without checking his own status.  By encouraging the couple I met to be tested together, the counselors hoped to stop that trend of spousal abandonment related to HIV.

When I inquired at the end of the session whether the husband intended to be tested for HIV as well, I was told that he had agreed to be tested.  The medical assistant warned, though, that ultimately the husband might still ignore the results and leave his wife.  Often the men will initially refuse to accept their status .  Only after a few months or years when their conditions worsen do they return to the clinic and seek treatment.  Nevertheless, testing couples together for HIV  remains one of the best methods to encourage immediate acceptance of the results and discourages spousal abandonment.

– Erin Boland

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