Integrated Regional Information Networks - February 14, 2012
JOHANNESBURG, 14 February 2012 (PlusNews) - No one said love was
easy. This Valentine's Day, IRIN/PlusNews brings you tips for
making love and HIV work, from a couple who've been there, done
that and stayed together.
Pholokgolo Ramothwala and his partner have been together since
they met through mutual friends in 2003. He's living with HIV,
she's not, and neither are their two children. Ramothwala gave us
their tips for living successfully and safely.
1. Understand the risk
"For the partner that's HIV-negative - help them understand what
they're dealing with. In the end, there's still the possibility
of HIV infection and if it happens they need to be prepared for
If you're not sure about the risks, get a second opinion from a
medical professional you trust. Finding the right doctor who is
supportive of HIV discordant couples is also important.
After disclosing to his partner, Ramothwala offered to take her
to his doctor for a one-on-one question and answer session. "I
wasn't even part of the conversation," says Ramothwala.
He also took his partner through what he knew about HIV
treatment, explaining disease progression and technical terms
like CD4 counts, which measure the immune system's strength, and
viral loads, which gauge the amount of HIV in the blood.
Ramothwala admits the temptation to have unprotected sex is there
for most discordant couples, but it's important to resist. "You
don't want to infect your partner and then regret for the rest of
your life that you should have done something about it."
2. Talk about sex
Every new couple has to figure out what works for them. Those
dealing with HIV also have to figure out what works with regards
to protection. The biggest mistake people make is thinking that
things will work themselves out - this is what puts them at risk,
he told IRIN/PlusNews.
"The other thing I've learned is that people don't talk about how
you have sex. There are some positions you're just not
comfortable with, there's a likelihood that you don't know where
the condom is and it might not even be 'in there', so make sure
that as a couple you talk about that."
"When you have built that communication bridge where you can talk
about anything it's easier for her to say, 'What do you think
Although it was about a year before these conversations got
easier for Ramothwala and his partner, it was worth it. Once
you're used to talking about lubricants, which can decrease the
risk of condoms breaking, and sexual positions, they become less
daunting and you learn to joke about them, he says.
3. Be prepared for emergencies
If you can, keep post-exposure prophylaxis (PEP) at home. PEP is
a 28-day course of HIV treatment used to decrease the risk of
infection after possible exposure to HIV, for instance in the
case of a condom breaking, or unprotected sex.
Although it's best to take PEP within the first 24 hours after
exposure, it can be taken at any time up to 72 hours afterwards,
according to South African guidelines. PEP has a relatively long
shelf-life of about two years.
An increasing number of discordant couples use PEP, and
Ramothwala and his partner also took the medication when they
were trying for the second child, having unprotected sex when his
partner was ovulating and then ensuring she took PEP afterwards.
4. Support each other
People say love is patient. "The partner who is positive must not
assume that what the negative partner is asking is stupid,"
Ramothwala told IRIN/PlusNews. "There's a reason they are asking
you that question." No question is "stupid" when it comes to
HIV often affects the sexes differently and it's an important
dynamic to think about, especially after the birth of a child
where an HIV-positive mother may be under harsher scrutiny than
an HIV-positive man in a discordant couple.
"In relation to the in-laws, women take more of the brunt of
[discordancy] when they're the ones who are HIV-positive,
especially in my culture where they'll ask why women aren't
breastfeeding" he says.
5. Plan for the future
Advice your Mom will love whether you're HIV-positive or not -
get life insurance. "One of the things I realised - like, five
years later - that you do need, is life cover," he says.
"I find that because I have children I worry about them, but once
you have life cover you know that they'll be protected. I grew up
without parents, so I know what that can do you."