Kathy Jacobs-McLoyd didn’t expect to fall in love with someone with HIV.
But when the man she had recently spent time volunteering with in Kenya sent her a six-page love letter, she opened up to the possibilities.
“One day early on, I turned to look at you or say something and my heart just kind of skipped a beat, it fluttered in my chest … and just as quickly rose to my throat leaving me momentarily speechless,” Peter McLoyd wrote.
Within six months, the Chicago-area couple were married. Now, they are among the country’s growing number of HIV sero-discordant couples – more simply, “magnet couples” who are attracted to each other even though one partner is positive and one is negative.
As the HIV epidemic moves into its third decade, people who are infected with the virus are living longer, healthier lives. As a result, they are dating, falling in love and forming families, sometimes with a partner who does not have the virus.
Nationally, 275 people per 100,000 are living with HIV or AIDS.
“I know more and more people who are choosing HIV-infected partners,” says Lora Branch, former director of the division of sexually transmitted infections and HIV at the Chicago Department of Public Health. “It’s not that unusual anymore.”
Their stories underscore the power of love to conquer fear. But such relationships can bring significant emotional challenges.
For the person without HIV, there is constant worry about the health of his or her loved one. For the positive partner, there is the fear of unintentionally passing on the infection.
And for both, there is often anxiety about how friends and family will react to the relationship.
Jacobs-McLoyd, 56, was moved by the love letter she received, but it went unanswered for several days. She knew McLoyd had HIV – he became infected as a result of intravenous drug use about 10 years ago – and she wasn’t sure she could get involved.
“Did I want to? Could I? What does this mean?” she remembers nervously asking herself.
In the end, she decided not to let a virus get in the way of love. The couple sealed their commitment with a City Hall marriage in 2004, followed the next year by a traditional African ceremony in Kenya.
“I knew him already,” she says. “I knew his character; people loved him. I thought he was a good catch. He was good-looking and sexy, and I thought, ‘Why not?’ ”
In some cases, the HIV-negative person goes into the relationship not knowing their partner is infected – either because the information is not disclosed right away or it is not yet known. The eventual disclosure can be an emotional land mine.
During the dating stage, the biggest hurdle for the HIV-positive person is when to tell the prospective partner, says Celeste Watkins-Hayes, an HIV-AIDS researcher and faculty fellow at the Institute for Policy Research at Northwestern University.
Later, as the relationship becomes more committed, couples often worry about whom to trust with the information, she says.
That issue can remain a sticking point until the couple comes to an agreement about which family members and friends should be told, says Rae Lewis-Thornton, an HIV-AIDS activist in Chicago who has lived with the virus for 23 years.
“For many people it is a difficult relationship because it comes with guilt on the infected person’s part. There is always this layer of stigma and shame, which is very real in this country, particularly in the black community,” says Lewis-Thornton, who was married to an HIV-negative man for four years before divorcing.
“That is a barrier that must be overcome before couples get to a really good place and can be comfortable.”
Joann Montes, 46, of Chicago says her boyfriend of eight years doesn’t want to tell his family that she is infected. As she has become more open about it – she was featured in a recent newspaper story about living with HIV – the public disclosure has put more strain on their relationship.
“We were friends before we dated and he knew about my status, that was never a problem,” Montes says. “The problem came when other people found out we were dating.
“There were friends who thought it was not a good idea for him to be dating me. They made comments like: ‘You can do better than that.’ ”
There’s also the challenge of protecting the uninfected partner during sex.
“Couples have to come to an understanding about what safety means in the relationship, and they have to follow it to the letter of the law,” Lewis-Thornton says.
“That can be harder as you become more comfortable in the relationship. If the condom breaks in the height of sex, do you stop and risk him being angry with you?”
Debbie Rivera’s husband, Mike, gets tested regularly for HIV and is uninfected, and the Chicago couple usually practice safe sex. But they agree that it is a challenge.
“There are times when we’re in the heat of the moment and we don’t take precautions,” says Debbie, 31, who tested positive for HIV in 1999.
She says the amount of virus in her blood is at undetectable levels because of antiretroviral medication, which greatly reduces the risk of transmitting it. And for biological reasons, women are less likely to transmit the virus than men.
However, health experts say the virus can still be transmitted and recommend regular condom use.
It is difficult to determine how many people with HIV are part of sero-discordant couples, because little research has been done, says Dr. Deborah Cohan, associate professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco.
“It’s a hidden population,” she says.
A study published in 2001 in the journal Family Planning Perspectives found that about half of the HIV-positive men and women who were surveyed about their desire to have children reported that their spouse or primary partner was HIV-negative, Cohan says.
Branch believes gays and heterosexuals make up an equal number of magnet couples, who span the demographic spectrum of race and class.
“The relationships that are most likely to last are ones where the healthy partner goes into it fully knowledgeable about the health risks, the medical challenges and other issues involved with being HIV-positive,” says Watkins-Hayes, who is also an associate professor of sociology and African-American studies.
“Those who enter these relationships unprepared for what it means are the ones most likely to fail.”
The McLoyds, who live in south suburban Matteson, Ill., say they decided to be interviewed about their relationship because they wanted to tackle the stigma surrounding HIV.
McLoyd is consumer development and advocacy coordinator in prevention and education at the CORE Center. Both have two children from previous relationships.
“We wring our hands about stigma,” he says of people with HIV and their advocates, “but we don’t do anything about it. By putting a face to it, you reduce the impact.”
Relaxing at home with their Great Dane, D’ogie, the McLoyds are comfortable in their relationship.
But Jacobs-McLoyd was reluctant to tell close family members about her husband’s HIV diagnosis. The mere thought of such a conversation caused her to take nervous deep breaths.
“In the back of mind there was this fear they would treat him differently when they found out he was positive, because of all the stigma,” she says. “I didn’t want to make a choice between family and my husband.”
Jacobs-McLoyd says she now sees she hadn’t given her relatives enough credit.
“I got really good feedback from those I’ve told,” she says.
The McLoyds say more resources should be available to support couples in their situation and they want to form a support group.
Although she fights the urge to be overprotective about her husband’s health, Jacobs-McLoyd says, the couple’s relationship is more typical than not.
“(HIV) doesn’t define who we are,” she says. “We are just a married couple like any other couple.”