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Rochelle and Rhonda are sitting next to each other, eating M&M's and recalling the day Rochelle almost died.
It was complications from Rochelle's HIV that landed her in that emergency room, so dehydrated, she says, that the doctors and nurses could barely squeeze one drop of blood out of her fingertip for tests.
"The lady in the emergency room, she said, 'Sister, you are just struggling,' " remembers Rochelle in a matter-of-fact voice. "And I said, 'What do you mean?' And she said, 'You're dead. But you're just refusing to lay down.' "
Rhonda, Rochelle's partner for the past year and a half, takes a deep breath at the memory. She's HIV-negative, and doesn't know what it's like to live with the illness. But as Rochelle's girlfriend, she is as close to it as she can get. She loves Rochelle, tries to make sure she takes her medications, urges her to stay on her special diets.
"I thought she was going to die right there," says Rhonda, remembering that day in the hospital. She takes off her glasses, rubs her eyes and looks sideways at Rochelle. "That screwed me up for a little while."
Rhonda keeps on talking in a soft, rough voice. She says her biggest fear is that one night the two of them will go to bed, fall asleep and Rochelle won't ever wake up in the morning.
"You love something so much, and you can't stop what's going on," says Rhonda, as tears begin to fall in earnest over her full cheeks. "You can only help it a little bit."
Rochelle sees Rhonda's tears but doesn't begin to shed her own.
"Don't you dare cry on me!" she snaps. "I'm not going anywhere! I'm too struggling to die."
For the next few moments, the two women alternate between debating and consoling each other. Rochelle says if the roles were reversed -- if Rhonda were the sick one -- she would be crying too. But Rochelle counters that she never gets "majorly sick." Wrong, argues Rhonda, remembering the times Rochelle's T-cell count dropped dramatically, or her colon began giving her problems. She ticks these events off on her fingers like a lawyer making a closing argument.
Rochelle sighs and says as long as she can walk around and talk to Rhonda, those things don't count. She thinks "majorly sick" will be when she won't be able to feed herself, or bathe herself. But Rochelle doesn't think about that time.
"I'm gonna be here," she says, her voice softening. "I'm gonna be here till time indefinite."
Rhonda stops crying, but she doesn't seem convinced. Being with Rochelle makes her so happy. But sometimes she's not sure how to handle the uncertainty that comes with loving someone with HIV.
"It can take you," says Rhonda to Rochelle. "It can reach out and get you at any given moment."
In medical jargon, Rhonda and Rochelle are known as a serodiscordant couple. Some experts use the less clinical-sounding "serodiverse," or "mixed status." But either way, the term is a simple one applied to couples who are made up of an HIV-positive and HIV-negative person. As a mixed-status couple, Rhonda and Rochelle are not an anomaly. It's been just over 20 years since the Centers for Disease Control and Prevention published its first mortality report on what came to be called AIDS, and with new, more aggressive HIV treatment extending the length and quality of HIV-positive peoples' lives, more of them are finding new opportunities to fall in love. And they often fall in love with people who are HIV-negative.
"We are seeing more now because people are living longer and living healthier," says Dr. Robert Remien, a clinical psychologist and professor at Columbia University. While there is no national resource center specifically for couples in Rhonda and Rochelle's position, Remien is one of the country's foremost researchers into the issues surrounding mixed-status couples. In the early '90s, in collaboration with the HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute, Remien developed The Couples Project, eight-week workshops that concentrated on problem- solving within mixed-status couples.
"Couples can feel isolated, and very closeted in their serodiscordant status," says Remien, who has worked with both gay and straight couples. "There is a lack of support -- they get a lot of negative feedback just for being in the relationship: 'Why are you doing this to yourselves?' "
The risk of transmitting the virus is often a secondary concern to the "psychological risks" these mixed-status couples can take, he says. Rhonda and Rochelle's argument is a textbook example of the issues that can surround both partners: grief, guilt, anger and fear of loss. Oftentimes, says Remien, these issues can feed on one another, creating a chain of dysfunction that can be broken only by regular, honest communication.
Ken McLeod, director of the Bering Support Network at Bering Memorial United Methodist Church in the heart of Houston's Montrose neighborhood, agrees. He has seen such a rise in the number of mixed-status couples in the Houston area that the support network has decided to start a special group just for them. While both McLeod and Remien say there is no way of knowing how many of the roughly 800,000 Americans living with HIV are in a mixed- status relationship, both say the issue can become only more important as time goes on and people continue to live longer lives with the illness.
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