HIV discordance refers to a situation where one of the partners is HIV positive while the other is HIV negative. According to Dr. Piriton, there are a couple of factors that cause this.
“A man is married to his wife, they have children and one is infected and the other one is not infected," he said.
"There are factors which make this possible. One, if this patient or person is on ARVs [antiretroviral drugs] and is taking them very well leading to viral load suppression or has an undetectable viral load, this person or this patient cannot transmit the HIV virus, unless his viral load changes. U equals to U, undetectable equals untransmissable.
"This person will stay HIV negative and the other HIV positive. But with much exposure, you can still get the HIV,” said the doctor.
“Two, to get the HIV virus there must be the help of what we call the CCR5 receptors. There are people who are naturally born with defects or issues with their CCR5 receptors. It simply means that HIV to enter your body, it is assisted by what we call CCR5 receptors."
"If you were born with defects or issues with those receptors, you can never get an HIV infection,” he adds.
Discordance care
Dr. Piriton goes on to advise particular care in case of discordance.
“If you are discordant, what we do in most cases we tell you to take PrEP [Pre- exposure prophylaxis, medicine taken to prevent getting HIV] this is for a person who is HIV negative as long as you are still exposed, you stay on drugs."
"It is different from PEP which is Post-exposure prophylaxis [HIV medicines taken within 72 hours (3 days) after a possible exposure to HIV to prevent HIV].
"In a discordant couple, the person who is HIV negative will take PrEP. PEP is taken by people who has been exposed already. They have gone in with someone who is HIV positive and they want to prevent HIV. They can take PEP,” says the doctor.
On the whole, the annual incidence of HIV among adults (defined as those aged 15 years and older) in Uganda is about 0.29%: 0.38% among women and 0.20% among men, according to the Population-based HIV Impact Assessment (PHIA).