Aren’t I Entitled to Know Why My Husband Is on a Drug for H.I.V. Risk?

My husband and I have been together since 1976. We have not always lived together, and we haven’t pledged to be monogamous. But neither have we had an ‘‘open marriage’’ or been promiscuous. An occasional fling when we have been traveling separately has been pretty satisfying. Recently I discovered emtricitabine out in the open in the bathroom. I looked it up and learned that it is generally used to fight the presence of H.I.V. in the system, or to prevent H.I.V. infection. I asked my husband why he had it. He accused me of ‘‘snooping’’ and said he neither has H.I.V. nor is putting himself — and me — at risk. I confronted him again recently. I’m waiting for him to come up with an answer. We are no longer having intimate relations. But I would still like to know what information he is keeping from me, and why. Do I have a right to know? — Name Withheld

From the Ethicist:

In a nonmonogamous marriage like yours, it’s important that you have a shared understanding about what’s acceptable. Committing yourself to a life with a person makes little sense if you can’t trust each other. And then in a sexual relationship, what’s safe for a couple to do together depends on how each behaves with others. Either way, he should have been open in answering your questions. It certainly wasn’t reasonable to accuse you of snooping, given that the drug — which is paired with other antiretrovirals in the treatment or the prevention of H.I.V./AIDS (and, less commonly, in the treatment of hepatitis B, or co-infections with both viruses) — wasn’t hidden from your view.

The natural assumption, from what he did say, is that he was taking the drug as part of a pre-exposure prophylaxis (PrEP) regimen, possibly instead of condom use. Unfortunately, the regimen doesn’t protect against many other sexually transmitted infections, and there are studies indicating a higher level of chlamydia, gonorrhea and syphilis among MSM (men having sex with men) on PrEP. (The C.D.C. has recently issued guidelines for doxy-PEP, post-exposure doxycycline, to help with that.) Even though yours is no longer a sexual relationship, you’re right to feel that marital trust requires being willing to discuss something like this. Sure, it’s up to your husband whether or not to disclose such information. But right now he’s treating you like a roommate, not a spouse. Marriage comes with expectations about commitment and communication. You should have an open, honest and nonjudgmental conversation about what’s going on with him; couples counseling might help you navigate this situation. Medical secrecy between spouses can have serious side effects.

Readers Respond

The previous question was from a reader who wondered if infidelity is ever permissible. He wrote: “I’m a man who recently had a fling with a man who is in a monogamous heterosexual relationship. … Normally I wouldn’t get involved with someone who is unfaithful. But here I felt my moral obligations to a struggling member of my own queer community were greater than those to his partner. The guy I had the fling with is not openly queer, but he reached out on an app for gay hookups. … Both of our encounters occurred in the apartment he shares with his girlfriend; we only ever met there because she consistently tracks his phone’s location and would confront him if he went anywhere without letting her know. . … His girlfriend has a right to know what’s going on in her relationship, particularly in terms of communication around the number of partners and protection. Whatever judgment I may have for her actions, I believe she deserves the truth. If I didn’t believe in the toxicity of their relationship and the danger of outing this man, I would be inclined to tell his girlfriend what happened, or make it clear to him that she must be informed. I think that my time with this person was meaningful for him and helped him to affirm his identity, even if our hookups were illicit. … I don’t know if I will ever really be able to settle my ethical stomachache about it all. Can there be stipulations on the immorality of infidelity?”

In his response, the Ethicist noted: “It takes two to cheat — well, at least two. But that doesn’t mean that there’s a moral equivalence between the cheater and the person with whom he’s cheating. The fellow you’re describing was the one who presumably had promised fidelity. Knowingly abetting his behavior was blameworthy, too, but less so: You weren’t the person betraying an intimate partner, concealing what you did and all the rest of it. Still, you’re making the right call to call it off. … None of this means you should tell her yourself, which would be a serious betrayal. He’s the one who owes her candor, and the fact that someone shouldn’t be left in the dark doesn’t mean that just anybody is entitled to turn on the lights. Nor does your belief that theirs is a terrible relationship entitle you to end it for them.” (Reread the full question and answer here.)

The Ethicist’s advice missed the mark on this one. The betrothed man keeping his same-sex hookups secret from his fiancée shows he’s already made the decision to not come clean with her about his true desires. Conducting his affairs in the couple’s own home adds another level of disrespect to this situation, which doesn’t bode well for their union. It’s terribly sad that this guy doesn’t feel free to live his truth. However, the woman deserves to know and decide for herself if she wants to move forward with the relationship. She should not pay the price of becoming his unwitting “beard” and potentially enduring years of unhappiness with someone who may not love or desire her. The letter writer knows the right thing to do, but if he’s torn about telling her himself, perhaps he can enlist the help of a friend or send her a screenshot of her boyfriend’s profile from the hookup app. If, after learning the truth, she’s OK with the arrangement, best wishes to them and their future together. Mary Ann

The Ethicist made many good points about how participating in infidelity can be harmful, as well as the problem with taking the cheater’s account of the relationship at face value. I once found myself in a situation very similar to that of the letter writer’s, though I didn’t find out he was married until after we had seen each other a few times. He, too, described a suspicious, controlling wife, but as he shared more specifics I realized that she was likely suspicious because she realized something was going on, and his mounting deceptions and denials were taking a toll on her mental health. I told him I couldn’t continue seeing him, but later wished I had offered to remain friends and provide support while he came to terms with his sexual identity and sorted out what he wanted to do about his marriage. He might not have taken me up on the offer, but at least he would have known there was someone willing to stand by and help, so he wouldn’t have to go through it alone. Andrew

I am a gay man who has had an intimate friendship with a mature straight-married man for many years. During this time, my friend has come to accept that he is indeed a gay man and were he to do his life over he would live openly as such. What he cannot bring himself to do is admit this reality to his wife, whom he loves quite sincerely. He knows how much this admission would devastate her, and is convinced it would destroy their marriage. So in order to spare her, he leads a double life. He would never have been unfaithful with another woman, but the undeniable reality is he needs physical contact with other men. He is certainly not comfortable with his deceit, but at the same time he is protecting her from the deep pain the truth would inflict. He has recently fallen in love for the first time with a younger gay man with whom he would live were he single. But at considerable emotional cost to himself, he is still choosing to remain in his marriage. Whereas moral absolutism would condemn his deceit and have him confess his sexuality to his wife, moral relativism can allow his duplicity to be imagined as a form of kindness. His difficult decision to lead a double life spares his wife a marriage-ending truth and as such seems the least destructive of his bad options. Christian

Speaking as a 60-year-old homosexual who has seen a lot of self-serving behavior in my time, I would say that the letter writer is no Clara Barton. He’s just a horny guy who took sex where he could find it yet wants to see himself as some sort of rescuer of the not-fully-out queer community. No good will come from his counseling, informing or otherwise manipulating activities. However much a mess his hookup’s life is, it will not be improved by the letter writer’s actions. Michael

As a middle-aged lesbian, I have grown tired of the narrative that being a sexual minority somehow negates one’s obligation to moral principles. If we want society to accept us, our marriages and our families, it’s best not to spurn widely practiced relationship norms such as monogamy. While it might still be difficult for some to come out, even in the United States, the dangers once posed to my community are thankfully mostly a thing of the past. I perceive the real challenge in this situation is a person’s ability to be honest with his partner and end their relationship if necessary. Affirming one’s identity need not have casualties. While the response from the Ethicist was spot-on, I will add my personal anecdote: The most identity-affirming moments I experienced as a young woman did not involve sex with other women, but rather spending time in queer spaces and being mentored by older gays and lesbians. Mellina

As the “girlfriend” in this scenario, this column hit close to home. I was in what I thought was a monogamous relationship with a man for nearly six years. It ended when he gave me a case of gonorrhea and admitted to having regular unprotected homosexual hookups throughout the duration of our relationship. Yes, dear Ethicist, in an ideal world it would have been nice if he could have been forthright about his sexuality — but how could that happen if he couldn’t even be honest with himself? Bottom line, in the real world I would have been grateful if any one of his hookups had tipped me off. At least it was only easily-treated gonorrhea and not H.I.V. If I saw him out with another woman, I would be sure to let her know what he had done to me. Trina

I agree with everything the Ethicist suggested, though I would like to add a caveat. I have a feeling that the letter writer wanted more from the man he was having this tryst with. His concern for a woman he doesn’t know is also puzzling. In keeping with queer ethics, no one has the right to “out” another person. Everybody’s journey is unique and it is not up to someone else (even one who claims to be well meaning) to decide when it is time for another individual to come out. Roberta

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