A better understanding of the impact of HIV treatment as prevention is changing the experience of those who are in a relationship with another serodiscordant partner, according to a qualitative study Australianpublished on the sociology institute, health and disease in Australia.A biomedical intervention seems to have unexpected effects - releasing the association serodiscordant relationships with the "risk" and helping couples to live their relationships as normal and safe.
Asha Persson of the University of New South Wales reports that the reviews on the treatment and prevention have significantly changed in the past a \ 9nos. She researched the subject in 2009, shortly after"Swiss statement"which says that anti-retroviral therapy (ART) reduces the risk of HIV transmission was issued. At that time, people in a relationship with a partner from another HIV status often expressed skepticism and uncertainty about the idea that HIV treatment can make a non-infectious person. They do not always see the relevance of the information for his own life.
But in his latest interview, held in 2013 and 2014, couples readily discussed the implications of having an undetectable viral load. HIV treatment seems to transform the social and sexual life of people living with HIV and their partners.
The research focuses specifically on the so-called "discordant couples" in other words, those in which a person has HIV and the other does not. The public health literature on serodiscordant relationships usually focuses on the risk of HIV transmission, and tends to see this relationship as inherently problematic. In contrast, Persson found that their respondents did fail to point out as normal and positive their relations were with HIV to be seen as, in other words as "not a big deal or anything to worry about."
Persson interviewed 38 people who were in a relationship with a sorodivergente from person to HIV in Australia. Members of 25 couples were interviewed, including 13 couples in which both partners were interviewed. Along with 16 gay couples, heterosexual couples had 7 and 2 couples that included transgender. 25 of partners, HIV-positive 20 were on HIV treatment and had an undetectable viral load, and 3 were about to begin. Half were diagnosed prior to his current relationship and the other half was diagnosed during the relationship.
About half of the couples had sex without a condom. Generally, heterosexual couples were monogamous and did not use condoms. Homosexual couples were more likely to have open contacts, and were also more likely to use condoms together.
Understanding of the treatment as prevention
Not all participants were familiar with the term "treatment as a preventive measure" (TASP - Treatment the Prevention), but it was found that there is a broad understanding of the concept that treatment reduces, yes, viral load and infectivity. Almost all respondents volunteered to your or your partner with an undetectable viral load, and the treatment was considered as the key to serodiscordant relationships.
However respondents had different perspectives on the implications of this.
Many gay couples framed the treatment of HIV as an "extra layer of protection" along with the use of condoms. Couples congratularizaram with the greatest sense of security provided by the treatment as prevention, but it was not to be used alone, as this man explained:
"If it 4% or 0,5%, there is still a risk ... if there is any risk, it makes sense, because the implications of the risks are so great ... the emotional impact of [my partner] knowing that he had given me HIV would be horrible to support ... "
Some other couples who had sex without a condom long before they learn about TASP to figure it congratulated and with this event that gives this assurance and validation for this choice:
"What happens is that this new information ... type confirmed what we did because that's why I'm still negative."
For another group of couples, the information about an undetectable viral load and infectivity "gave them permission" to have sex without a condom.
"And then the study realized that serodiscordant couples found it a discovery of great importance [...] ... so they felt like they really relieved and able to go ahead ... I could sit there and say ' go ', "These are the facts. If he has his medication every day ... I'm willing to take the risk, because I know what he's doing everything possible to keep me safe. '"
At all levels, TASP (treatment as prevention - "TCP") decreased by anxieties about transmission, with HIV-positive partners explained the woman:
"[It] helps you to be able to relax and enjoy your sex life, enjoy your relationship with your partner. It's one less thing to worry about. "
Many of those interviewed claimed not to be concerned about HIV transmission, with many of the HIV-negative partners have shown to be particularly interested in refuting the idea of being at risk or its partners be contagious. They wanted to put this risk into perspective("I know that the probability of not reaching transmission is not zero, but I know it's very low, very low")and it does not define their relationship as dangerous.
"I can not see how I can have a loving relationship with Iasmim (not her real name) and be concerned about or fear of becoming HIV-positive ... it just seems to be incompatible with this fact."
An HIV-positive patient, who had ruled the sex or relationships with HIV-patients negativosdo male is said to be a relationship with a man and that he was not worried about his sorodivergências:
"I think I've been living my sexuality in a very limited way and see how it all had to work for me; and now I feel freer ... I can truly love who I love, instead of being limited to "or not you are HIV positive? "(...) It gives room for, you know, relationships happen, can evolve, I think once thought would be impossible these levels of progressiveness."
Combat stigma and transformation of relations
"TASP makes possible new ways to experience and imagine their sexuality with serodiscordant people," Persson writes. Because TASP is able to change the perception of HIV as being highly infectious, it "can work normalizing gradually and legitimize intimate serodiscordant relationships as something that can be" worked "and then appreciated, instead of being questioned as an anomaly in sexual need for continuous risk or risk management. "
It says that a pharmaceutical product - that is, the way in which the product is seen - can have an impact on the stigma. Antiretroviral parecme be helping to restore a sense of nomal social and sexual life (SIC) in people living with HIV, allowing them to live life a full life.
In contrast, many other sociologists have taken a critical approach to the increased use of pharmaceutical products to manage complex problems that have social causes, including depression, obesity and sexual dysfunction. Because it can enhance the normal behavior of ideas and appearance, it is sometimes seen as a form of social control, where people feel pressured to use drugs to bring their bodies to align to socially expected standards.
The interview revealed that some HIV-negative patients of respondents pushing its partners to ART and maintain an undetectable viral load as a condition "sine qua non "to maintain the relationship.
"I feel much more relaxed and comfortable when my partner is making use of antiretroviral medication ... it solves a whole series of tensions."
ButGöran PerssonIt says that, in general, is more optimistic, focusing on the potential of TCP to transform our understanding of HIV in much more interesting and positive ways. TCP is not only a tool for public health, but can also improve the relations of intimacy and sexual pleasure. It can help bridge the "sorodivergência" between HIV-negative and HIV-positive people, allowing the relationships between them, can be felt as safe and legitimate, and not as a "homicidal / suicidal" relationship ...
The definition of "safe sex" is expanding, which can not simply be defined as the use of condoms. The focus of HIV / AIDS prevention is the change to change sexual behavior and encourage people to start their ART (anti-retroviraOl treatment and aderiemr her with spartan rigor. And the significant evolution of the views of people since its previous study 5 years ago suggests that new changes and developments are likely to form not inevitable.
Note the Soropositivo.Org translator: I still remember how it had been before yesterday I realized I have been more than eight months without receiving a hug and how painful was this feeling ... The tension during sex were numerous and often I removed the penis of the partner's vagina to see if the condom was not broken and of course it chilled any transaction. Until the day I met my wife, there are already 12 years and this is no longer a big deal to be a low-risk problem. Fortunately things have evolved and I hope this is not a matter to be denied in five weeks ... On the other hand, this opens very large margin to make them to stop arresting people for murder (no dead victim often) simply because it did not disclose their HIV status before sex and I hope to remove the chain a man who was sentenced to 33 years in prison for "attacking a policeman with deadly weapon (spit in the face) there in the USA, the land of Uncle Sammy; and, of course, to be released all HIV-positive Brazilians who are in prisons, literally withering alive without receiving medical treatment which is a constitutional right (Health is a duty of the state and the right of all)
Produzido by HIV and Hepatites.com, and AIDSMAP.com translated and reviewed by Claudio Souza the original Awareness of Treatment Impact on HIV Transmission is Transforming Lives of Mixed-status Couples
Persson A. "The world has changed '': Pharmaceutical citizenship and the reimagining of serodiscordant sexuality Among couples with mixed HIV status in Australia.Sociology of Health and Illness. September 11, 2015 (early access).
If you found any error Portuguese in this text, edited frantically around 3: 30 morning please, please, inform me about the error using the form below. Your identity will not be mentioned and your email address will not be revealed, neither God nor the devil. I hate and despise spammers