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 nonmonogamousmarriage 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?”