Love in the time of HIV

2014-11-30 15:00

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A decade ago, Jabu Mahlangu and Bheki Nyalungu’s relationship would have appeared doomed from the start – and they probably wouldn’t have been planning to have a baby.

Mahlangu is HIV positive. In the early 2000s, that diagnosis was a death sentence and women with the virus were encouraged not to have babies. Some were sterilised without their knowledge or consent because doctors and nurses feared their unborn children would be infected.

But that was almost a lifetime ago, before South Africa’s attitudes to HIV and Aids began to shift, and treatment became a right.

Today, more than 2.7?million people receive free antiretrovirals (ARVs). Mahlangu (31) is among them. She started treatment in 2007.

Nyalungu (35) is HIV negative. They are what’s known as a serodiscordant couple, whose statuses differ. The two, who are from Mayfield on Johannesburg’s East Rand, met three years ago. In a way, it was HIV that brought them together.

They were both sitting at a local salon waiting to have their hair done when Mahlangu started chatting openly about her status and how ARVs were treating her. It was this bravery that stole Nyalungu’s heart.

“I knew there and then that this was the woman for me,” he said.

“I loved her boldness as she openly spoke about her status, not bothered about who was listening or not.”

Mahlangu, who volunteers with the Treatment Action Campaign (TAC), is always open about her condition.

It was a lucky meeting in more ways than one.

“Her timing was just perfect because I was convinced I was HIV positive. The mother of my child had died of Aids-related illnesses a few years back,” Nyalungu said.

He tested negative after his former girlfriend died in 2002, but was certain nurses at the clinic had made a mistake. Meeting Mahlangu inspired the taxi driver to be tested again – he was negative.

Last year, the couple decided to have a child. Where 10 or 15 years ago this may have horrified doctors and nurses, today it’s considered quite safe.

Francesca Conradie, clinical adviser and president of the HIV Clinicians’ Society, said as long as Mahlangu was taking her ARVs and adhering to her ARV schedule, and her viral load was suppressed, the risk of her infecting Nyalungu was slim to none.

The couple is avoiding the pricier methods for now and trying the old-fashioned way for a baby: unprotected sex during ovulation.

They both have children from previous relationships.

“It is our dream to create a life together,” said Mahlangu.

“We started trying last year, but so far we have not had success. But I haven’t lost hope because I’ve checked my tubes to ensure there is no blockage. I’ve also been to a private doctor who has given me medication to induce ovulation so that we have increased chances of conceiving.”

Nyalungu said he had not lost hope of conceiving a child with his partner.

“We have unprotected sex during her fertile days and I know it will happen. Neither do I fear getting infected because Jabu adheres to her treatment.”

They are excited about raising a child of their own.

“Jabu is a great mother to her daughter and I know she would be a great mother to our child, too,” Nyalungu said.

The science of serodiscordance

Francesca Conradie, clinical adviser and president of the Southern African HIV Clinicians’ Society, says there’s no reason for HIV-positive people not to be leading perfectly ordinary lives – whether their partners are positive or not.

“If an HIV-positive person is taking ARV treatment and adhering to it, the chances of infecting their partner or unborn child are very slim and, in some cases, nonexistent.”

She makes it sound simple, but research says it really is. Studies have shown that within six weeks of starting ARV treatment, a person’s viral load – the amount of the virus that’s in the body – is undetectable. That means the person is no longer infectious.

There’s also no reason for people living with HIV not to have children or to try to fall pregnant.

She sees no problem with having sex without a condom the old-fashioned way – if the HIV-positive partner is taking the ARVs as prescribed.

“Also [a couple] can do artificial insemination – which can cost more than R10?000 – or do the insemination at home by having sex using condoms,” she says.

“After the man ejaculates into a condom or cup, they can pour the semen into a syringe before releasing it into the vagina.”

Another process that can be used is sperm washing, in which the individual sperm are separated in a laboratory from the semen and certain disease-carrying material extracted. The washed sperm is then injected into the woman using an artificial insemination technique.

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