Sero discordance is a situation in which one of the partners in a sexual relationship tests positive for the HIV. On the other hand, sero concomitance is a situation in which both partners in a sexual relationship test positive for the HIV.

A colleague of mine related to me a case of an acquaintance who was married to another man for about 10 years and they frequently had unprotected sex. At the close of ten years, the man died of AIDS. The woman later on married another man and he also tested positive of HIV and in about 10 years died of HIV/ AIDS. The woman continued to live her life and tested her HIV status regularly. In all the while, she was negative. The most mind boggling question is that, “why did she not contract the HIV?”

In another separate but yet related incident, the wife of a close friend of mine tested HIV positive during her pregnancy. She got the Prevention of Mother to Child transmission intervention medication and the child was born negative. The child is about 5 years old now and very healthy. The wife suspected she got the HIV from the husband. They went to test their HIV statuses and the husband was negative while the wife was positive.

There was of course the counselling phase that was done and put away and then the reality. The reality was that each one of them had to do a very thorough soul searching.

Each individual had to ask themselves what is love to them? Are they in an asymptomatic transition period? Were they betrayed through unfaithfulness during the course of the relationship or not? Did the other party know that they had contracted the HIV? The other party that is negative, is s/he willing and prepared to be HIV positive in future in case of improper use of condoms? Does the couple continue having sex or not? Does the couple include other sexual partners to cater for the changed situation? Will there be any grain of trust left in the relationship? What are the implications of each decision taken in the long run of the relationship?

A lot of HIV/ AIDS programmes within the work place and training interventions have focused much on the pedagogic aspect of HIV/AIDS and its morbidity. While this is helpful, l contend that a paradigm shift has to occur. People do not benefit much if they are not exposed to knowledge, skills, attitudes and support systems relevant to their circumstances. Knowledge of the prevalence of the disease while it may be appreciable, it is not relevant for the infected and immediately affected.

Stress management is often recommended. This is also helpful if it is relevant. In this context, relevant means that the stress management course empowers an individual to answer the questions raised above as opposed to teaching them about ego defence mechanisms.

Sero- discordance has its own adverse impact and implications in the workplace. There is a shift in sick leave patterns, absenteeism and financial expenditure inclined to medical treatment. Management is yet to grasp fully and adapt its style of management and leadership in view of this. Policies and organisational practices are yet to be updated from their cenozoic era.

To be continued….what is your take?





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