"It was clear that he was afraid of me"

How people with HIV are looking for partners - and why they prefer people with the same status

In Russia, more than a million people live with HIV infection. Now, according to the statistics of Rospotrebnadzor, the main way to transmit the disease is unprotected sex between a man and a woman (only in 2020 almost 65% of people with HIV infected). And although it has long been known that HIV-positive people cannot infect someone in everyday life or with ordinary friendly communication, the disease is still surrounded by many fears. Therefore, often people with HIV choose to build relationships with people who have a similar status. "Cold" talked with them about the choice of a partner and problems related to this.

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"Who will I need this diagnosis?"

Marina ( the name changed at the request of the heroine ) found out that she had HIV, in 2006, when she went to donate blood as a donor. At first she thought that this was a mistake, but she was sent to the local AIDS center, where a second analysis confirmed the presence of the virus. “I was in shock, for some time I did not live, but simply existed. On this basis, I even tried to commit suicide several times, turned to a psychiatrist for help. Now it’s scary to remember that condition, ”says Marina.

When she tried to understand where she could become infected, she decided that the only option was unprotected sex. In 2005, when she was 22, Marina began dating a young man. When it came to sex, Marina asked him to put on a condom, to which he said: “Are you worthy of something? Here I am - no. " Now Marina is very sorry that she did not insist on defense. “The young fool was, gripped. I thought we would have a serious relationship, and the guy just disappeared after sex. So, when I recognized my status, I didn’t even have the opportunity to tell him, ”she says.

“I remember, even when we talked, this guy introduced me to his friend. A friend tried to tell me something all the time, but my boyfriend plugged his mouth. I think he was afraid that a friend would tell me about his diagnosis, ”says Marina.

Due to the status of HIV-positive, Marina began problems at work: she secretly spoke about the diagnosis of her colleague, and she blabbed her husband. “Once this man came drunk to our work, began to humiliate me at all, insulted me, said that he would kill me or put me. He was completely insane. I still have a sediment on my soul. There were times when I came across aggression in the hospital. Once the doctor said that I could infect him, and refused to serve me. Of course, not all people treat me like that, but very many are afraid because they know little about the disease, ”says Marina.

For a long time, she believed that she would not be able to build relationships with a healthy man, because “no one would need this“ plus ”with this.” Then Marina still began dating an HIV-negative partner, but the relationship quickly ended. “I wanted a child, but that man was afraid and thought that the child would be born sick. And in general it was clear that he was afraid of me, it was scary to get infected. ”

Infectious disease specialist Elena Orlova-Morozova, the head of the outpatient and vicineline department of the Moscow Regional Center for the Combating of AIDS, explains: with the regular and prolonged administration of antiretroviral therapy ( the method of HIV therapy, in which the disease takes antiviral drugs daily. surrounding even with unprotected sexual contact. “In 2019, the results of the second phase of the Partner study were published , in which 1670 discordant couples (such where the partners have different HIV-Status) from 14 countries of Europe took part. At the same time, HIV-positive stably took Arv therapy, and sexual contacts between partners took place (as before the start of the study) without the use of a condom. During this study, scientists did not record a single case of HIV transmission, ”she emphasizes. “There were 26 sick people, but when studying the virus it turned out that a person received an infection somewhere outside the couple: he had another strain of the virus, not like a permanent partner.”

According to Orlova-Morozova, including due to this study, changes were made to international clinical recommendations-from them the recommendation of discordant couples was removed only to secure sex. Before these changes, partners with various HIV status used the Eco Procedure for conception.

“The results of the“ Partner ”study are key to confirm the principle of“ H = N ”, that is,“ uncertain = not transmitting ”. This means that a person who is on ARV therapy cannot infect someone, since the viral load ( the number of copies of the virus in one milliliter of blood.-approx. “Cold” ) in his blood decreases to such a level that it cannot be determined by existing test systems, therefore it is called “uncertain,” explains Orlova-Morozov. However, today, according to Rospotrebnadzor, only 53.2% of people living with HIV receive treatment.

Healthy children in HIV-positive parents are also born under the condition of regular, without gaps, taking ARV therapy. But the HIV-positive mother can not feed the baby with breast milk, since a small amount of the virus may fall into it, for example, if a woman in the postpartum turmoil once or twice forgot to accept therapy. “In the Moscow region, HIV-positive parents per year give about about 1% of children with HIV infection. That is, for 500-600 children who appeared in HIV-positive mothers, the infection is transmitted only to 3-5 babies. This happens if the mother did not know about her diagnosis and did not receive treatment. When a woman finds out about pregnancy, she becomes registered in a antenatal clinic and necessarily gives a blood test for HIV. If it turns out to be positive, it is sent to the AIDS center and therapy is prescribed. But when a woman does not go to the doctors-often these are socially not adapted people who use drugs, for example, then the chance to give birth to an HIV-positive child is quite high, ”says the infectious disease specialist.

For some time, due to unsuccessful relations, Marina did not meet with anyone, and after 30 years she began to see only HIV-positive men. In groups for dating HIV-positive people, Marina has already found several pleasant interlocutors. “I have not yet gone on dates, but I communicate a lot in correspondence, we call up with some men. I do not want to be alone, I want to meet my person. So that it was a good person, economic, kind, loves children. So that we create a family, give birth to a child, and we were good and comfortable. That's all. Therefore, I write to these groups, ”says Marina.

" I was afraid that they would start yelling at me"

Elena Ivanova, HIV-positive activist and coordinator of projects of the Association E.V.A. , says that there are still many “horror stories” around HIV infection: for example, that the virus is transmitted through kisses, general towels or mosquito bites. For this reason, healthy people can believe that even friends with HIV-positive is dangerous, not to mention romantic relationships. Because of this stigma, people with HIV are scary and ashamed to talk about their status. “When I found out the diagnosis and decided to inform him to my loved ones, my words literally stuck in my throat,” Elena recalls. “It was a shame for myself, I was afraid that they would begin to yell at me, that people would stop talking to me, thinking that I was dangerous.”

In addition to social stigmatization, self -amization also takes place. “This phenomenon is very common among HIV-positive ones. When people get a positive test, they are deeply shocked: how so? After all, this is very embarrassing, this is not about me, ”adds the infectious disease specialist Elena Orlova-Morozova.

The conviction of an HIV-positive person is that he is dangerous for others, can involuntarily reinforce doctors. According to activist Elena Ivanova, sometimes even AIDS centers are told to patients that the use of a condom in a couple is mandatory, and unprotected sex leads to an infection of a partner. Elena Orlova-Morozova believes that doctors do this out of a desire to be safe. “The principle of“ uncertain = non -transmitting ”is undeniable, statistics here have a high degree of evidence. However, among doctors there are those who are afraid of whatever it happened. Therefore, they recommend that patients always use a condom, just in case. ”

Stygmatization often leads to the fact that an HIV-positive person decides to build relationships only with other HIV-positive ones-after all, in such a pair you will not be rejected due to the diagnosis, and there is also no danger of infecting another person.

Another reason why HIV-positive people decide to build relationships only with each other is the fear of going to prison. In Russia, as in most other countries, there is a criminal liability for infection of HIV infection (Article 122 of the Criminal Code). When a person becomes registered with the AIDS center, he is asked to sign a document that he knows about this responsibility. “People sign this paper, as a rule, without particularly delving, but simply by reading. Naturally, a person who only learned about the diagnosis is in a state of stress and remembers only one thing - that now he can really go to jail. It's scary. So some choose to start relationships only with HIV-positive partners in order to avoid the risk of falling under this article, ”says Elena Ivanova.

“The responsibility provided for in paragraph 1 (the deliberate supply of another person in the danger of infection of HIV infection) or part 2 (infection of the other person with HIV infection by a person who knew about the presence of this disease) of Article 122 does not occur when an HIV-positive person warned a partner in advance about his illness and that he could also become infected,” says lawyer Anna Anna Kryukova. -If such a conversation took place, and sex on a voluntary mutual agreement has occurred, they will not punish anyone, even if the HIV-negative person became ill as a result of sexual contact. Although the presumption of innocence has been established against criminal liability, an HIV-positive person must make sure that the fact of notification of another person has been proven. However, I emphasize: this is described in the note to the law and applies only to part 1 and 2 of this article. This does not apply to Part 3 (when the act was committed against two or more persons, as well as in relation to a minor), ”says the lawyer.

According to the sanitary rules in force in Russia (for example, the resolution of the main state sanitary doctor “HIV prevention from 2011), ARV drugs play a significant role in the prevention of the disease, but do not exclude the risk of infection completely. The same goes for condoms. Anna Kryukova advises HIV-positive people to take into account all these factors when they decide whether to warn a partner about their diagnosis or not.

“In any case, just for sex with an HIV-negative person does not put anyone in prison. To decide whether the HIV-positive person will be punished or not, the court must investigate everything: the composition of the crime, whether there was intent, whether a person pleads guilty. Only after this will the verdict be made, ”says Anna Kryukova.

But even if an HIV-positive person, consisting in relations with a healthy partner, observes all precautions so as not to violate the law, he may encounter active condemnation from others. “I have an HIV-negative husband, and many know about it. Not everyone agrees with my choice. Even in the support group for HIV-positive people, you can encounter condemnation, for example, recently one HIV-positive acquaintance told me that I should meet only the same as me, and now I am in jealous of infecting a healthy person, and this is wrong, ”recalls Elena Ivanova.

"I will not take responsibility for someone else's life"

30-year-old Larisa Vasilieva from the Moscow region learned that she had HIV, three months ago. It turned out by accident: when she donated blood for hospitalization, the analysis showed the presence of a virus. “Six years ago, I took an analysis for HIV, and then I was completely healthy, so I suspect that the man with whom we started dating five years ago infected me,” says Larisa.

When Larisa found out about the diagnosis, she wrote SMS to her then partner: "I am suspected of HIV, they sent for a second diagnosis." The man was surprised and asked where Larisa was infected. "I said:" I think that from you. " Besides him, I had no one during these five years, so only he could infect, ”she recalls. After this conversation, Larisa passed a second analysis, which confirmed the diagnosis. “I wrote about this to the partner and asked if he handed over the analysis himself,” she says. “He said not.” After that they broke up.

Larisa admits that after she recognized her HIV status, it was in shock for some time. “I read about illness for three days, I was looking for information. As a result, I met an HIV-positive man who told me how to live with a diagnosis. Then I reconciled with my status and calmed down, ”says Larisa.

Larisa registered in the center of AIDS and began to take therapy. She knows that HIV-positive people can meet healthy, but does not consider such an opportunity for themselves. “I believe that HIV-positive person is much more comfortable with a partner of the same status. Such people understand each other, lead the same way of life, and there is no fear of infecting and infected, ”she says.

Larisa also thinks that HIV-negative person will not build relationships with HIV-positive due to the instinct of self-preservation, and in principle doubts the safety of relations in discordant couples. “I am categorically against relations with a healthy man: nothing guarantees his safety,” she said. - The viral load is checked only in the blood, but not checked in vaginal discharge and sperm, which means that you can get infected through them. In addition, the load may be vague today, and tomorrow to jump. I will not take responsibility for someone else's life. ”

Infectious disease specialist Elena Orlova-Morozova does not agree with Larisa. “It is unlikely that in the blood the viral load will be uncertain, and in other fluids - high. Studies were conducted, which showed that the smaller the blood virus, the smaller in other biological fluids. And then: when infection occurs during sexual contact, this usually happens due to microtrauma, that is, through the blood. It all depends on how conscientiously a person takes ARV therapy. If he does not miss the tablets, then the viral load in the blood and other liquids will remain at the uncertain level, ”she says.

The longer a person is treated and the longer he has an uncertain viral load, the better. “If only yesterday we achieved a minimum viral load, then there is a risk that for some time there will be“ bursts ”of the virus in the blood and other liquids. When the patient drinks tablets, for example, six months, this probability strives for zero, ”adds Orlova-Morozov.

It warns that it is dangerous to pass the techniques of ARV therapy because because of this, resistance to one or more drugs may develop, and treatment will not be effective. “If a person regularly passes five to six doses of therapy per month, then a new stable strain of the virus occurs in the blood, which prescribed drugs no longer suppress. In this case, the viral load will really grow, but this will certainly be visible in the analyzes. The attending physician always knows what to do in such a situation. ”

Now Larisa is looking for a man rather for regular meetings than for a serious relationship. “I don’t want a common life, common life. Go somewhere together, chat-this will be enough, ”she says. Larisa has children: a son and a daughter who were born before she was infected with HIV, so she is not going to get married or get common children with a new partner.

Larisa found the HIV-positive people for dating by HIV-positive people: she scored the UBC abbreviation “HIV” in the “VKontakte” search line, and this community fell among the first results. “I left a message there on the wall that I was looking for a partner, and immediately clarified: only HIV-positive. But still healthy men often write to me, sometimes they don’t even say hello, but immediately demand that they send them a photo. However, for me spiritual qualities are more important than appearance, so first I need to talk with a person, to understand whether it is interesting for us or not, and then look at the appearance. Why will I send my photos to everyone if I have nothing to talk about with these people? ”

Larisa wants her partner to be serious and ready to take responsibility for her life: “I do not like it when they dump your failures on fate, Putin and so on. I really want a person to accept my views and not teach me life. And to be kind - without cruelty, which is so much in modern men. ”

«У меня ВИЧ, но мы все равно занимаемся сексом без презерватива»

Есть и другие причины, по которым люди с ВИЧ ищут отношений с людьми с таким же статусом. В тематических сообществах некоторые мужчины признаются, что ищут партнершу с таким же статусом, потому что у них давно не было секса без презерватива.

«Я что, должен искать здорового партнера, чтобы его заразить? Отношения со здоровой женщиной — это бред. Если только с презиком, иначе это опасно, да еще и статья Уголовного кодекса за это ( статья 122 УК РФ «Заражение ВИЧ-инфекцией». — Прим. «Холода» ), — написал в ответ на просьбу об интервью один из участников группы во «ВКонтакте», посвященной знакомствам ВИЧ-положительных людей.

Другой участник сообщества, 47-летний Сергей Иванов из Тольятти, по его словам, пользовался презервативом только один раз в жизни — когда ему было 22 года. О том, что у него ВИЧ-инфекция, Сергей узнал в 2015 году. Он говорит, что заразился от девушки, с которой в то время жил. «Я знал, что у нее ВИЧ, но как-то об этом не волновался», — признается он. Поэтому сексом пара занималась без презерватива. «Это не принцип, просто презервативы — не для меня. Да и девушки многие их не любят. Вот вы любите нюхать цветы в противогазе?» He says.

О своем статусе Сергей узнал случайно, когда лежал в больнице с лимфостазом ( состояние, которое возникает при нарушение работы лимфатической системы. — Прим. «Холода» ). Диагноз его не шокировал, Сергей сразу встал на учет в местный Центр профилактики и борьбы со СПИДом и начал принимать антиретровирусную терапию. По его словам, вирусная нагрузка у него сейчас «очень маленькая», а за время приема лекарств количество лимфоцитов в крови поднялось с 430 до 620 единиц на миллилитр крови ( у здоровых людей норма — 800-1200, у ВИЧ-положительных при благополучном течении болезни это число может превышать 500 единиц на 1 мл крови. — Прим. «Холода» ).

Однако, как говорит Сергей, даже после обнаружения у него ВИЧ-инфекции он не стал предохраняться во время секса, хотя отношения у него были и со здоровыми девушками. «Конечно же, я всем им говорил о том, что у меня ВИЧ, предупреждал о последствиях. Одна мне на это ответила: ВИЧ — не приговор. Глупо... Хотя, конечно, не приговор. Мы с той девушкой до сих пор иногда переписываемся, она совершенно здорова», — рассказывает Сергей. Сейчас он продолжает встречаться со здоровыми девушками, хотя говорит, что чувствовал бы себя спокойнее с ВИЧ-положительной партнершей.

Семейный психолог и специалист по работе с сексуальными дисфункциями Марина Травкова объясняет, что люди, практикующие незащищенный секс, часто делают это из-за того, что не вполне представляют последствия рискованного поведения. «Про курение мы знаем, что оно вредно, но люди все же курят. Why? А вдруг последствия наступят не сразу, а вдруг они будут несерьезными, а вдруг это случится не со мной», — говорит психолог. Так же на их поведение влияет низкий уровень сексуального просвещения. «Во многих ситуациях у людей просто нет необходимого поведенческого паттерна. Никто в школах не рассказывает, как отказать парню, если у него не оказалось презерватива. Никто не говорит, что нравственность и заболевания, передающиеся половым путем, между собой не связаны, ведь заразиться можно и в браке, и в самый первый раз», — объясняет Марина Травкова.

Наконец, отдельным пунктом психолог выделяет пренебрежение здоровьем: «Это некая национальная героическая традиция: мы умеем преодолевать, но не умеем профилактировать».

По словам психолога, чаще всего пренебрегают средствами защиты во время секса мужчины. «Для многих презервативы — это в первую очередь про защиту от беременности, - объясняет она. - А в нашем обществе страх забеременеть, а также обязанность разбираться с последствиями этой беременности все еще считаются головной болью женщины. И женщины, понимая эти риски, чаще думают о контрацепции».

«Фиксироваться на заболевании не стоит»

ВИЧ-положительная активистка Елена Иванова считает, что «на одном только диагнозе отношений не построишь". "Я сама через такое проходила: у меня были отношения с ВИЧ-положительным мужчиной, с которым мы познакомились на группе поддержки. В какой-то момент я поняла, что не хочу строить с ним семью, но уговаривала себя: зато у вас обоих ВИЧ-инфекция, не надо будет рассказывать ему о диагнозе, унижаться. Однако затем я поняла, что мне ценности человека, его принципы и черты характера гораздо более важны, чем его ВИЧ-статус», — рассказывает она.

По мнению Ивановой, дискордантные пары нередко создают крепкие семьи, потому что в них у людей более прочная связь друг с другом, основанная на доверии и принятии. «Когда человек остается рядом с тобой даже после того, как узнал о таком неприятном с точки зрения общества диагнозе, это очень важно и вызывает большое уважение и доверие», — говорит она.

Предприниматель, совладелец digital-агентства «Herocode» Евгений Грезин рассказывает, что его команда изучила в интернете страницы для знакомств людей с ВИЧ и обнаружила, что они старые и неудобные, а многие попросту заброшены. «В основном это разрозненные сообщества в соцсетях. При этом подавляющее большинство экспертов, с которыми я общался, сказали мне, что запрос на подобные проекты есть», — рассказывает он.

Из-за этого бизнесмен решил создать сервис знакомств наподобие Tinder под названием Swipe.Plus — сейчас он находится в стадии разработки. Сам Грезин — ВИЧ-отрицательный, но говорит, что его беспокоит проблема дискриминации и одиночества ВИЧ-положительных людей. «В большинстве случаев ВИЧ-отрицательный человек, узнав о положительном статусе нового знакомого, просто прекратит общение из страха за свое здоровье. Когда люди с ВИЧ встречают подобную реакцию раз за разом, у многих из них в принципе пропадает желание знакомиться, — рассуждает Грезин. — Они могут замыкаться в себе, на своей проблеме. В результате некоторые ВИЧ-положительные начинают искать пару только среди “своих”».

Активистка Елена Иванова считает, что сайты знакомств только для людей с ВИЧ делают вклад в их стигматизацию, потому что эти сообщества как бы «запирают» людей в отдельном пространстве. Однако для тех, кто только узнал о диагнозе, важно чувствовать, что они остаются полноценными людьми с правом на личную жизнь и отношения. И для них такие сайты, а также группы поддержки для ВИЧ-положительных людей, где есть возможность пообщаться в том числе с равным консультантом (человек, живущий с ВИЧ и прошедший подготовку по консультированию. — Прим. «Холода») , — это безопасное пространство, которое дает возможность справиться со стрессом и одиночеством, отмечает она.

Грезин согласен, что такие сервисы и приложения, как Swipe.Plus, в каком-то смысле сегрегируют общество. Однако прямо сейчас, по его мнению, у проекта в случае запуска будут плюсы, которые перевешивают этот недостаток. «С одной стороны, можно сидеть и ждать, пока общество станет более продвинутым. С другой — у людей жизнь проходит прямо сейчас, — говорит он. — Вот сидит какой-нибудь одинокий человек в Перми и не знает, что ему делать, как найти друзей, построить семью. Ему остается либо ждать, когда же общество изменит к нему свое отношение, либо воспользоваться сервисом, где он найдет поддержку и общение прямо сейчас. А через какое-то время общество наконец станет более спокойно относиться к ВИЧ-положительным. Но, честно говоря, я не думаю, что это случится на моем веку».

«Все способы знакомств, которые есть среди ВИЧ-положительных людей, имеют право на жизнь, - говорит инфекционист Елена Орлова-Морозова. — Кому-то действительно легче найти партнера на группе поддержки. Но я считаю, что фиксироваться на заболевании все же не стоит. Зачем сужать круг поиска? Любовь и так найти трудно, а если ограничиться только людьми с диагнозом, то будет еще сложнее. Но, конечно, это личное дело каждого человека — с кем ему строить отношения».

Люди с ВИЧ, которые испытывают трудности с принятием своего статуса, столкнулись с травмирующим отношением общества, испытывают тревогу или чувство вины из-за своего диагноза, могут получить бесплатную консультацию психолога Ассоциации Е.В.А. Кроме того, поддержку специалиста могут получить партнеры ВИЧ-положительных людей в дискордантных парах, а также специалисты, работающие с ВИЧ-положительными людьми: учителя, юристы профильных организаций, сотрудники медицинских и социальных учреждений.