Relationships Between Serodiscordant Gay Male Couples in Lima, Peru: Sero-Disclosure and Living with Serodiscordance

In Peru, the HIV epidemic is primarily concentrated among gay men. Treatment for HIV became available in 2004; however both HIV and gay relationships remain highly stigmatized. Epidemiologic studies notwithstanding, the lack of research on either serodiscordant or gay relationships in Peru led us to conduct the first qualitative study on gay couples with the same, different, or unknown HIV serostatus there. In this chapter we focus on 19 gay men in stable, serodiscordant relationships. Our analysis showed that HIV-positive partners were often hesitant to disclose, assuming their HIV-positivity would threaten the relationship. However, once disclosure occurred, relationships adapted to serodiscordance. Improved HIV treatment influenced this dynamic; negative partners saw that treatment works, leading to less fear of HIV and its transmission. Indeed, HIV was often less challenging for these couples than other issues they faced, particularly social censure around same-sex relationships in Peruvian society. We conclude that serodiscordance appears to be evolving in Peru. Increased longevity and better health outcomes for people with HIV make people more comfortable with HIV within their relationship; nonetheless, couples survive within a highly stigmatized environment, influencing their ability to access support and circumscribing the increased comfort with HIV in the context of relationships.