Love, drugs and condoms: Couples with different HIV status face a new reality

Robert Ochweda and Millicent Akoth is HIV affirmative — she caught nan microorganism from her erstwhile husband. She is now joined to Robert Ochweda, a fisherman who is HIV negative. After nan 2 of them fell successful love, he says he was acrophobic to wed her lest he statement nan virus. "I person been capable to enactment safe by utilizing condoms and PrEP," Ochweda explains, referring to a pill that prevents infection. In nan aftermath of U.S. overseas assistance cuts, they opportunity it's go harder to find nan pills and condoms that support them safe. Julia Gunther for NPR hide caption

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Julia Gunther for NPR

Let's opportunity you autumn successful emotion pinch personification harboring a deadly -- and highly infectious -- virus. And you deliberation … is it crazy to get married?

Sometimes emotion conquers each — pinch nan thief of modern medicine.

That's nan communicative of serodiscordant couples — nan word utilized erstwhile 1 partner is HIV affirmative and nan different is HIV negative.

Robert Ochweda and Millicent Akoth of Kenya are 1 specified couple. She is HIV affirmative — she caught nan microorganism from her erstwhile husband. He is simply a fisherman who is HIV negative. After nan 2 of them fell successful love, he says he was acrophobic to wed her lest he statement nan virus.

He was capable to flooded his fears.

"I person been capable to enactment safe by utilizing condoms and PrEP," Ochweda explains, referring to a pill that prevents infection. And The Centers for Disease Control and Prevention writes: "Most condoms are highly effective successful preventing HIV."

His woman takes antiretroviral pills that trim her viral load, truthful she does not look nan consequence of decease from AIDS. Those pills besides trim nan consequence that she will infect her husband.

This year, couples successful this class are particularly anxious. They opportunity that, successful nan aftermath of nan Trump administration's melodramatic overseas assistance cuts and dismantling of USAID, nan agency that supported health-related programs, it's go harder to find nan pills and condoms that support them safe.

Caleb Ochieng, who is HIV negative, has been joined to DIana Odhiambo, who is HIV positive, for 8 years. They person 2 children. On a caller sojourn to prime up his PrEP narcotics that trim his consequence of infection, he says, "I was told nan proviso that was disposable has been reserved for pregnant women." Julia Gunther for NPR hide caption

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Julia Gunther for NPR

Caleb Ochieng, who is HIV negative, has been joined to Diana Odhiambo, who is HIV positive, for 8 years.

Ochieng learned of Odhiambo's HIV position erstwhile they went to do an HIV trial arsenic they made plans to necktie nan knot aft respective years of cohabiting. She believes she contracted nan illness from a erstwhile relationship.

"We were shocked because astatine that clip we had 2 children and wanted others. We were advised connected preventive measures for illustration condom usage and voluntary antheral circumcision arsenic a measurement of preventing HIV infection," he says.

"I wondered really we would manage," he recalls. "It's not been easy but pinch love, we person been taking attraction of ourselves."

Odhiambo takes pills to suppress nan virus; he takes pre-exposure prophylaxis (PrEP) to enactment safe. He is tested for HIV each 3 months.

Taking these precautions, nan mates has had 2 children who are HIV negative. After counseling, Odhiambo has go a adjacent pedagogue who talks to different couples successful nan aforesaid situation. The partner who is positive, he reflects, "has a batch of emotions. AS a partner, you should beryllium location for them and support them well."

On a caller sojourn to nan session wherever he picks up his PrEP drugs, he says, "I was told nan proviso that was disposable has been reserved for pregnant women. I traveled to neighboring Busia region and managed to get a mini dose that could past a period and a half."

His acquisition echoes a memo from nan State Department that NPR obtained, stating that if a session receives backing done nan U.S. programme PEPFAR, this preventative medicine tin "only" beryllium fixed to "pregnant and breastfeeding women" during nan 90-day frost connected overseas assistance that nan Trump management instituted — and that is still successful effect.

A elder wellness charismatic pinch nan Kenyan Ministry of Health told NPR that clinics person been rationing medications and different supplies because of nan uncertainties astir philanthropist funds.

"We get astir of nan HIV medicine done partners and donors. The exit of U.S. backing intends that location is simply a gap, and until that spread is filled, location is ever bound to beryllium clash but nan authorities has done everything to support operations going," says nan official, who asked not to beryllium identified by sanction because he did not person support to speak to nan press.

Joywine Adek, a programs serviceman astatine Mildmay Kenya, an statement that supports HIV patients, is seeing this gap.

Mildmay Kenya is among nan organizations that was receiving backing from nan U.S. authorities to support HIV interventions successful Kenya, including screening services, distribution of antiretroviral narcotics and condoms, and counseling for serodiscordant couples.

"In nan existent assistance that is disposable aft nan simplification successful funding, location is nary support for discordant couples," Adek says, adding that nan kindness has had to halt galore of its services because of nan nonaccomplishment of U.S. aid.

"We are trying to benignant this retired by doing what we telephone integration of HIV attraction into regular wellness care," says Fredrick Oluoch, nan head of nationalist wellness successful Kenya's Kisumu County.

The deficiency of condoms is evident. This newsman saw quiet dispensers wherever co Kndoms were erstwhile stocked and made disposable successful clinics.

Empty condom dispensers astatine a kindness called Mildmay Kenya, which supports group who are HIV positive. According to nan United Nations Population Fund, nan U.S. cuts successful overseas assistance person had an effect connected nan proviso of free condoms for those successful need. Julia Gunther for NPR hide caption

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Julia Gunther for NPR

And moreover though condoms are inexpensive — arsenic small arsenic $1 aliases $2 each successful nan U.S., moreover little successful Kenya — that value could still beryllium daunting successful a state wherever a 3rd of nan organization lives beneath nan poorness statement of astir $2 a time successful income.

Kenya has antecedently reported that nan proviso of condoms was not adjacent to nan demand. But this year, officials say, things are worse than ever successful nan aftermath of nan U.S. overseas assistance shakeup, which has affected immoderate of nan suppliers, for illustration nan United Nations Population Fund (UNFPA).

In a connection to NPR, UNFPA noted: "Kenya has historically relied heavy connected USAID for its free condom distribution programs. Kenya's yearly condom request is estimated astatine 400–450 cardinal units. Condom procurement by UNFPA has been affected indirectly — but nevertheless importantly - by U.S. backing cuts. While UNFPA continues its domiciled successful condom programming done backing from different world partners, nan U.S. extremity activity bid has contributed to shortfalls successful supply, putting much unit connected UNFPA and different providers. Some 9.8 cardinal UNFPA-procured condoms were received astatine nan Kenya Central Stores connected August 13, 2025, but backing restrictions from nan U.S. and different donors mean location is uncertainty arsenic to whether UNFPA will beryllium capable to meet projected condom procurement needs for 2026 and beyond."

NPR asked nan State Department to respond to these points astir U.S. backing and free condom programs but did not person a response.

The consequence of this altered assistance scenery is that partners pinch different HIV position are surviving pinch newfound uncertainty.

"The shortage of nan narcotics and condoms is simply a awesome interest for us, and nan authorities is yet to reside our concerns," says Erastus Ng'uono, who is HIV affirmative and joined to Winnie Auma Miyare, who is HIV negative. The mates is opinionated successful beforehand of their location pinch 2 of their children, a boy named Rain and a babe woman named Rose. Says Ng'uono: "I don't cognize what nan early holds." Julia Gunther for NPR hide caption

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Julia Gunther for NPR

Erastus Ng'uono was calved pinch HIV affirmative status. When he met Winnie Auma Miyare and wanted to commencement a narration pinch her, he asked her if she could emotion personification who is HIV affirmative and utilizing ARVs. A fewer days later, he told her astir his HIV status.

At first she did not want to person thing to do pinch him. But erstwhile he explained really medications could thief her ward disconnected infection, she changed her mind. She takes PrEP pills. They person 4 children who are each HIV negative. Their youngest is six months old.

The news of U.S. assistance cuts that could impact nan strategies they usage has deed them hard. "I encouraged him to person courageousness and not to worry," she says. "I cognize nan authorities will intervene."

"I was very afraid," he says. "I moreover prayed complete it and I cognize God will spot america through."

Still he worries. "The shortage of nan narcotics and condoms is simply a awesome interest for america and nan authorities is yet to reside our concerns," says Ng'uono. "I don't cognize what nan early holds."

Viola Kosome is simply a Kenyan journalist. See much of photojournalist Julia Gunther's activity on her website or travel her connected Instagram: @juliagunther_photography.