Are there any special challenges to counseling discordant couples?
How does it differ from your regular VCT counseling? Well, you have three scenarios when you’re giving results to couples. The first and happiest one is they’re both negative, and that’s obviously the easiest one because then you’re trying to reinforce behaviors to keep them both negative, and there’s a huge sense of relief and a renewed commitment to the relationship and faithfulness. Then you have a situation where both partners are positive, and that presents a challenge because they have to think about the kids they have and the fact that they might not live to raise those kids, and planning for their own health and the family’s future and all kinds of things. But obviously there’s less focus on transmission from one to the other because they both already have it. With discordant couples, of course it’s more complex, you have to support the HIV-positive person as an individual with HIV and their health issues and concerns, whether they’re symptomatic or, more usually, asymptomatic.
