Can HIV Positive Couples Lead A Happy Conjugal Life?

Dr Shoma A Chatterji *

Pix Credit :: Bunti Phurailatpam

In Gujarat, people living with HIV are looking at a new therapy – marriage within the community of HIV positive people. Activist activist G.V. Joshi cites the example of a diamond worker Manohar, who was HIV positive and unmarried when he met his future wife Sujata at counselling meetings. Sujata too was HIV positive having caught the virus from her ex-husband. The two decided to tie the knot. A jubilant Manohar says that, "This marriage has proved to be the best decision of my life."

He feels that it has brought him a sense of peace because he does not have to hide his affliction from his wife and she knows exactly how to handle his special needs for high-protein food and regular medicines. "We understand each other's physical and emotional needs,"-- the couple chorus together. They have decided not to raise a family at all.

Earlier Manohar had been under tremendous pressure from his family to marry some woman without informing her about his illness. But he could not bring himself to live with the guilt of passing on the virus to an unsuspecting girl. Manohar's personal take on such marriages between HIV positive couples, who have already crossed the border of safety and are destined to die, is the strong antidote of companionship that helps in fighting the disease.

The Gujarat State Network of People living with HIV and AIDS (GSNP), has started the first ever marriage bureau for people living with HIV in the state, as it believes that marriages between HIV positive people may herald a new beginning-- both in the efforts at preventing the spread of the disease and in giving a new meaning to the lives of these people. GSNP counsels HIV positive couples to refrain from having children, as they would run a high risk of being born with the infection.

But the main problem they face is that the number of young men living with HIV far exceeds the number of young women living with the virus. Moreover, many women living with HIV are sex workers and the social stigma attached to the profession prevents even HIV positive men from marrying these girls. However, if more such networks and communities are formed in all states, more men and women living with HIV can get married and bring some sunshine in their desolate lives.

The definition of the term 'family' has changed radically over the past two decades across the world. The normal family structures are still there but there have been many permutations and combinations which demand that we enlarge the scope of our social acceptance. One dimension of this crisis is marriage between couples where either one or both of the two partners are living with HIV. There are other dimensions too-- did one or both know the status of their partner before they were married? Or, did the illness occur after they tied the knot and this endangered their relationship?

These questions seem too become redundant in cases where death is just round the corner and one can do nothing about it. So, how do couples live with the constant thought that they will die soon? Does life become a hollow entity stripped of all meaning? Many men and women living with HIV are getting married without letting their secrets out and trying to infuse some quality and positive thinking in whatever is left of their lives.

Ramakrishnan and Mary, who are both living with HIV and are members of the South India Positive Network, are another such couple who got married in Chennai. A routine medical test showed Ramakrishnan's HIV positive status while Mary had caught the virus from her ex-husband who died of AIDS some time ago. As their children could be born with the virus, they are considering adoption as an option or even foregoing having kids altogether. Theirs is just one example of a conscious couple who are leading a protected and happy married life despite the deadly virus.

While normal couples often match horoscopes and blood groups, HIV positive couples intending to marry are advised to match their CD-4 counts that indicate the immunity level of the affected person. Once the HIV virus enters the body, it attaches itself to a white blood cell called CD-4 or alternatively called T4 cell. They are the chief fighters of disease in the body. Whenever there is an infection, CD-4 cells lead the infection-fighting army of the body to protect it from falling sick.

Damage to these cells can affect a person's disease-fighting capability and general health. The number of CD-4 cells per millilitre of blood (called the CD-4 count), ranges between 500 and 1500 in a healthy person. According to an HIV/AIDS specialist, when the CD-4 count drops below 200, a person falls prey to infections like TB, pneumonia and some forms of cancer. A person with CD-4 count above 400-500 is considered absolutely disease-free.

Premilla D'Cruz's study, 'In Sickness and in Health–The Family Experience of HIV/AIDS in India (2003)', explains how in some cases, where the progress of the husband's infection had not reached a stage that could affect the well-being of the family, HIV and its implications led to greater bonding between the spouses. There was a greater sense of support and protectiveness between them. Problems increased, in direct proportion to the husband's degree of infection, when he has been responsible for having invited the disease by visiting sex workers, drinking, gambling and leading an immoral life.

In such cases, concern, support, compassion and protectiveness co-existed with anger and resentment in the wives. The anger results not as much from the husband's promiscuous lifestyle as it does from the financial, and emotional impact of the disease on the entire family. The unhappiness in sex life gets mitigated over time. However, most wives did not express their resentment openly because they felt it would increase the pain the husband was already reeling under. Love within marriage, as we all know, is not just about sex and having children. It is about a shoulder you can rest your head on, a mind you can reach out to, a person who shares happiness and joy with you all through your life.

Men living with HIV can marry HIV negative women if the latter are well informed about the affliction and still willing. They can lead a protected and normal conjugal life, but should not have any children. However, many are under pressure from their families, especially when the parents do not know that their child is affected and the child is afraid to let the parents know the truth. Dr. Sanjay Govindraj, an AIDS counsellor in Bangalore, said to Citizen News Service - CNS, "If both the man and the woman are aware that they are carrying the virus, there is no problem if they want to get married. The counsellors, instead of advising them against marriage, should help them make up their minds."

Shyamala Ashok, AIDS counsellor, Pondicherry, also thinks that, "HIV positive men and women would be psychologically better off if they get married to each other."

So here is wishing success to more such consensual marriages which are bound to bring happiness in the couples' lives by sharing the joys and sorrows of their partners.