Continued from page 1

It started in Africa more than 20 years ago. Researchers believe couples testing has successfully reduced the spread of AIDS among married, heterosexual couples in some African regions. One study that looked at couples where one spouse is HIV positive and the other is HIV negative estimated that couples testing was cutting the rate of transmission by more than half.

In Washington, D.C., where the rate of HIV infection rivals some African nations, some community agencies allow couples to test together. Family and Medical Counseling Service Inc. has been testing about 145 couples together annually since 2008. Most are heterosexual couples.

In Chicago and Atlanta, Testing Together, funded by the MAC AIDS Fund, hopes to test 400 couples by the end of the year.


Each participant in Testing Together signs a consent form that addresses receiving counseling, testing and results with a partner in the same room at the same time with a trained counselor: “I hereby consent to allow my partner to know the results of my HIV test,” it begins.

The program challenges conventional practices in the United States, where HIV testing is usually private and for individuals only. At most other clinics, a man who asks if his partner can be there when he hears his test result is denied because of patient confidentiality concerns.

There are two trends fueling Testing Together. One, the number of gay Americans telling the U.S. Census they’re living with same-sex partners nearly doubled in the past decade, to about 650,000 couples. About half those same-sex partnerships are gay men.

What’s more, a new line of research suggests that up to 68 percent of new HIV infections in gay men come from a main sex partner, not from casual sex, in part because main sex partners are more likely to forgo condoms.

Counselors are trained on how to deliver test results, with particular emphasis on how to tell partners the most difficult news: one partner has the virus and the other doesn’t. With these so-called “HIV discordant” couples, counselors have a great opportunity to reduce the spread of the virus by helping the couple learn ways to protect the uninfected partner, primarily through correct and consistent condom use.

Counselors are trained to dispel myths. If the couple thinks the test result means one partner has been unfaithful, the counselor might point out that the infected partner could have acquired HIV before the partner became a couple. If the couple believes the virus is “sleeping” and can’t be transmitted, the counselor might explain that HIV can be transmitted even if there are no signs or symptoms. If the couple believes their status is proof that precautions aren’t needed, the counselor might explain that HIV could be transmitted in the future as the infected partner’s virus levels rise.

Sam Hoehnle is a counselor in the Chicago program. “It never becomes easier emotionally” to deliver the news to an HIV discordant couple, Hoehnle said. He tells the HIV negative partner his results first, then spends more time and attention on the HIV positive partner. He’s seen partners support each other, but he acknowledges he can’t read minds. A show of compassion could mask anger or fear.

“You don’t know what’s happening internally, in their heads, about how they’re feeling about each other,” he said.


Poteste and Zemanovic got the best news possible: They were both HIV negative.

They both laughed with the sheer relief of it. The counselor had been nonjudgmental and hadn’t wanted to talk about the past, only the future, pressing them to talk specifically and directly about their agreement on sex outside the relationship.

Story Continues →