A better understanding of the impact of HIV treatment as prevention is changing the experience of those in a relationship with a partner of another serodiscordant, according to an Australian qualitative study published on the sociology institute, health and disease in Australia. A biomedical intervention seems to have unexpected effects - freeing the association of serodiscordant relationships with "risk" and helping couples to live their relationships as normal and safe.
Asha Persson of the University of New South Wales reports that views on treatment as prevention have changed significantly in recent years. She researched the topic in 9, shortly after the "Swiss statement" which says that antiretroviral therapy (ART) reduces the risk of HIV transmission has been emitted. At that time, people in a relationship with a partner from another HIV status often expressed skepticism or uncertainty about the idea that HIV treatment can make a person non-infectious. They do not always see the relevance of information for their own lives.
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 so-called "serodiscordant couples," in other words, those in which one person has HIV and the other does not. The public health literature on serodiscordant relationships generally focuses on the risk of HIV transmission and tends to see this relationship as inherently problematic. In contrast, Persson found that his interviewees wanted to fail to point out how normal and positive their relationships were, with HIV being seen as, in other words as "not being big thing or something to worry about."
Persson interviewed 38 people who were in a relationship with a person from the HIV serodivergente in Australia. Members of the 25 couples were interviewed, including 13 couples in which both partners were interviewed. Along with 16 homosexual couples, there were 7 heterosexual couples and 2 couples who included transsexuals. Of the 25 partners, HIV-positive 20 were undergoing HIV treatment and had an undetectable viral load, and 3 were about to begin. Half of them were diagnosed prior to their current relationship and the other half were 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 Prevention" (TasP), but there was a broad understanding of the concept that the treatment reduces viral load and infectivity. Almost all of the interviewees volunteered for their partner with an undetectable viral load, and treatment was considered 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 had intercourse without a condom long before they learned about TasP upon discovering that they congratulated it 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 the serodiscordant couples discovered in this a discovery of great importance ... then they felt like they were truly relieved, and able to go forward ... I could sit there and say, go, '"These are the facts. If he takes his medication every day ... I'm willing to take the risk because I know he's doing everything he can to keep me safe. "
At all levels, TasP (treatment as Prevention - "TCP") decreased 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 the respondents claimed they were not concerned about HIV transmission, with many of the HIV-negative partners being especially interested in refuting the idea of being at risk or their partners being contagious. They wanted to put this risk in perspective ("I know the probability of reaching non-transmissibility is not zero, but I know it's too low, too 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 have lived my sexuality in a very limited way and see how it all had to work for me; and now I feel more free ... I can really love who I love instead of being limited to: "Are you HIV positive or not? "(...) It gives space to, you know, relationships happen, they can evolve, I think I once thought that these levels of progressiveness would be impossible."
Combat stigma and transformation of relations
"TasP makes possible new forms of experiences and imagine their sexuality with serodiscordant people," Persson writes. Because TasP is able to change the perception of HIV as being extremely infectious, it "may function by gradually normalizing and legitimizing intimate serodiscordant relationships as something that can be" worked "and then appreciated, rather than being problematized as an anomaly in the sexual need for continued risk or risk management. "
It states that a pharmaceutical product - that is, the way in which the product is perceived - can have an impact on stigma. Antiretrovirals seem to be helping to restore the sense of nomadic 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 increasing the use of pharmaceuticals to manage complex problems that have social causes, including depression, obesity and sexual dysfunction. Because this may reinforce the ideas of normal behavior and appearance, it is sometimes seen as a form of social control, in which people feel pressured to use drugs to get their bodies aligned 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."
More Göran Persson, says he is generally more optimistic, focusing on TCP's potential to transform our understanding of HIV into much more interesting and positive ways. TCP is not only a tool for public health, but it can also improve the relationships 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 changing the way sexual behavior is changed and encouraging people to initiate antiretroviral therapy (ART) and adhere to it with Spartan rigor. And the significant evolution of people's opinion since their previous study 5 years ago suggests that new changes and developments are likely if 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)
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 have found a bug in this text, edited frantically around 3: 30 in the morning please kindly inform me of the error using the form below. Your identity will not be mentioned and your e-mail address will not be revealed to God or the devil. I loathe and despise spammers
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