PATNA: Cases of marital discord among serodiscordant couples, where either partner is positive to the human immunodeficiency virus (HIV), which causes AIDS, a chronic immune system disease, are slowly rising in Bihar, pointing to lesser tolerance, family commitment, and bonding between such couples, feel people living within the community with HIV/AIDS.
There has been a 10% increase in reported cases of marital discord in Patna during the past decade, said Rita Kumari, 32, a member of the Patna Network Project for People Living With HIV/AIDS, registered under the Societies Registration Act in Bihar. The community-based organisation, under the Bihar Network of People Living with HIV/AIDS Society or BNP+ umbrella, works on National AIDS Control Organisation projects, routed through the Bihar State AIDS Control Society (BSACS).
“Marriages have gone awry in 10% cases of 466 serodiscordant couples among the 6,852 HIV cases reported since 2013 at Patna’s two anti-retroviral therapy (ART) centres at the Patna Medical College Hospital (PMCH) and the Rajendra Memorial Research Institute of Medical Sciences, both government facilities,” said Kumari.
“The new trend emerging now is of HIV-negative women turning hostile towards their HIV-positive spouse,” she added.
Pooja Mishra, 31, secretary of the BNP+ dittoed Kumari.
“Earlier, we would only come across cases of marital discord among serodiscordant couples where the woman was HIV positive and her male partner negative. Of late, we have started getting a few cases of HIV-negative women rejecting their HIV-positive spouse,” said Mishra.
CASE STUDIES
Sita Devi (name changed), 35, a housewife, in Top, a small village in Daniyawan block of Patna, has left her husband, Shankar Kumar (name changed), 39, a migrant labourer, after he tested positive two months back. Shankar used to work in Delhi and would generally return home only during festivals.
Sita was not prepared to accept her husband as she believed he had cheated on her by indulging in multi-partner sex, said Kumari.
Patna’s Rambabu Ram (name changed), 40, tested HIV positive in 2019-20. Two years later, after Ram transferred the ownership of his Agamkuan house to his spouse, Rekha Devi (name changed), 35, threw her husband out. Both have lodged police complaints.
Somewhat conventional is the case of Buxar’s Roma Kumari (name changed), 28. She stays with her mother and keeps shuttling to the women’s police station in the district after her husband, Suraj Kumar (name changed), 31, dumped Kumari, suspecting her character. Suraj, a gateman in Indian Railways, posted in Maharashtra’s Nagpur, deserted his wife after she tested HIV positive in 2020.
Roma chokes when she talks about her broken marital life.
“My husband doubted me and forced a miscarriage of our first child by resorting to physical abuse during the pandemic, when I was in Nagpur, after which I returned home with great difficulty during the nationwide lockdown and lodged a police complaint against my husband in August 2020,” said Roma.
Roma now alleges that the police were not doing enough to arrest her husband.
BIHAR’S CASE BURDEN
Bihar had cumulative 16,584 serodiscordant couples, out of the 76,160 total cumulative cases of people living with HIV/AIDS and on ART in March. The total number of active cases of serodiscordant couples has come down to 10,068 as of March since the HIV/AIDS intervention programme began in the state in 2006, as per BSACS data.
HIV positive males accounted for 70% of the 10,068 active cases of serodiscordant couples. The female partner was HIV positive in the remaining 30% cases, said BSACS officials.
The decline in the number of serodiscordant couples was either due to the other partner turning positive, death of either partner or shifting of such couples to some other state, said officials.
There has also been an annual decline in the number of new serodiscordant couples since 2019. From 1,063 new serodiscordant couples reported among 10,209 new HIV cases registered during FY 2019-20, their number declined to 974 among the 9,963 new HIV cases in 2022-23.
Bihar’s total cumulative HIV/AIDS burden was 60,544 in 2019-20, which rose to 63,448 in 2020-21; and 67,601 in 2021-22, revealed BSACS data.
WHAT EXPERTS SAY
Social scientist Gyanendra Yadav, 59, an associate professor of sociology in Patna’s College of Commerce, said the level of commitment and family bonding as man and wife was fast declining in people belonging to the lower and upper socio-economic strata of society.
“Those from the middle class are still somewhat tolerant and try to preserve the reputation of a relationship and family, but people from the lower and upper strata largely believe in a tit-for-tat policy, and have greater intolerance. Since HIV is perceived to be generally associated with multi-partner sex, either person is not willing to accept that his/her partner has cheated, leading to broken marriages,” said Yadav.
Psychiatrist Dr Narendra Pratap Singh, 62, said there was a strong taboo about sexually transmitted diseases in the society.
“Since HIV/AIDS is essentially perceived to be associated with sexual activities, the guilt among women is more than men about indulging in multi-partner sex, and now they prefer to break a marital relationship if their partner turns HIV positive,” said Dr. Singh, professor and head, department of psychiatry, PMCH.
“The sense of chastity, aggressiveness, and marital dominance is more among men. As such, males, especially among migrant workers, have no inhibition of indulging in sex with their spouse despite having multi-partner sexual contact outside their home. The same person becomes ignorant and intolerant when he gets to know that his spouse is HIV positive,” added Dr. Singh.
“The chances of early sexual exposure in both urban and rural areas are very high due to easy access to internet. People have made their own hub of disinhibition, like watching pornography or resorting to other sexual activities among their peers, and the fear of HIV among them has diluted,” added Dr. Singh.
The BSACS, through its interventions, has relentlessly strived to keep such couples serodiscordant for as long as possible.
“As part of our effort to provide serodiscordant couples an opportunity to lead a normal life, we have improved supplies and shortened the procurement time lag to less than two months by doing rate contract of drugs and testing kits through the Bihar Medical Services Infrastructure Corporation Limited,” said Anshul Agarwal, former project director of BSACS, now the district magistrate of Buxar.
“In either case, I don’t think any spouse should leave his/her partner in such trying times, especially when one needs physical, emotional and mental support the most. We need to spread more awareness because HIV/AIDS is not associated with unfaithfulness alone,” said Alankrita Pandey, project director of BSACS.
