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When HIV Figures in Family Life: Exploring the Relational Reach of Serodiscordance

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Abstract

Social research has been building an increasingly powerful challenge to the public health framing of HIV serodiscordance as pertaining only to sexual transmission risk within couple relationships. Aligned with this critique, our qualitative research with couples of mixed HIV status in New South Wales, Australia, revealed that serodiscordance held relational and cultural meanings which extended beyond the couple domain, encompassing a range of other relationships and issues, particularly those pertaining to families. A deductive thematic analysis of the data on families within these interviews revealed two major themes, disclosing serodiscordance to extended family members, and pursuing serodiscordant parenthood, which presented different challenges for same-sex and opposite-sex couples. We conclude that, despite incredible advances in the medical management of HIV, there continue to be diverse implications of serodiscordance within both intimate and extended family relationships. Understanding the implications of disclosing serodiscordance beyond the couple relationship, and recognising the complex intersections between the public and private dimensions of serodiscordance, offer promising ways forward in supporting families affected by HIV in settings which are culturally comparable to Australia.

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Notes

  1. There is growing scientific evidence from Africa that the risk of mother-to-child transmission through breastfeeding is extremely low. WHO guidelines now support a mother to breastfeed if she lives in a resource-limited setting, is taking ART and has achieved an undetectable viral load, managed well over time, on the basis that the risk of malnutrition, infections and mortality resulting from formula feeding is greater than the risk of HIV transmission (WHO 2010). However, in many high income settings, including Australia, HIV positive women are still recommended to avoid breastfeeding, because there remains a very low risk of mother-to-child-transmission and formula feeding options are safe (NAPWHA 2017).

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Acknowledgements

We are very grateful to the participants who so generously shared their stories so that others could learn from their experiences of serodiscordant relationships. This work was supported by the New South Wales Ministry of Health. The Centre for Social Research in Health receives funding from UNSW Arts and Social Sciences, and from the Australian Government Department of Health. The Australian Federation of AIDS Organisations receives funding from the Australian Government Department of Health.

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Authors and Affiliations

  1. Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia

    Christy Newman & Asha Persson

  2. Australian Federation of AIDS Organisations, Sydney, Australia

    Jeanne Ellard

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  1. Christy Newman
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  2. Asha Persson
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  3. Jeanne Ellard
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Correspondence to Christy Newman.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Newman, C., Persson, A. & Ellard, J. When HIV Figures in Family Life: Exploring the Relational Reach of Serodiscordance. Sexuality & Culture 22, 1527–1541 (2018). https://doi.org/10.1007/s12119-018-9542-2

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