Living in an HIV-discordant couple: challenges faced by gay men in Mexico City
Background: There are few studies about HIV discordant couples, despite an increasing possibility of these union formations due to new antiretroviral therapies. The aim of this study is to analyze the challenges that HIV-discordant gay couples (only one partner is HIV-positive) face in intimate and broader social contexts like health institutions. The focus is on the problems these couples confront as they are viewed by each member and the connection with their social context. Implications for health programs are discussed.
Methods: In-depth interviews in Mexico City with 44 men in HIV-discordant gay couples were analyzed. Topics explored were sexual practices before and after knowing their HIV-discordance, sexual identity, challenges of living in a relationship, and experiences with family and health institutions. For the analysis, separate matrixes of topics were built for HIV-negative and HIV-positive men, respectively.
Results: Living in an HIV discordant relationship represents special challenges. HIV-negative respondents complained about
(a) putting their own needs in second place, and (b) dealing with partner’s mood changes due to antiretroviral therapy. HIV-positive men reported (a) fears of loosing their uninfected partner, and (b) a constant battle to keep their self-esteem up. At the same time all interviewees highlighted common issues like social discrimination and stigma, difficulty to share their HIV-discordance with relatives, fears of infection or re-infection, and sexual dissatisfaction due to preventive practices they have to take. For both men, the common axis that worsens all these problems is their exclusion from social institutions due to stigma and homophobia.
Conclusions: Even with recent legal recognition of consensual same-sex unions in Mexico City, discrimination against HIV-discordant gay couples still exists, making difficult integral health assistance to each partner. Health institutions need to train their personnel to fully recognize the rights of same-sex couples and to offer them adequate care as a dyadic unit.
-Abstract available at link below-