HIV Couples: When They’ve Got It, But You Don’t

    A couple smiling at each other, woman touching man's neck.HIV isn’t the first topic that comes up when most couples start dating. You may not know the HIV status of your partner. You might not even have been tested yourself.

    It can be very difficult to talk about HIV status, but it’s very important for couples to discuss this, not only for health, but to achieve a greater degree of trust and intimacy in the relationship.

    So what are the most important facts that couples need to know?

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    Couples with one person who is HIV-positive and one who is HIV-negative are sometimes called “serodiscordant” or “mixed serostatus”. “Sero-” refers to blood serum.

    “Serostatus” refers to whether someone has HIV infection or not.

    What Are the Special Issues for Mixed Couples?

    People in mixed-status relationships face all the same things as other couples. But there are some extra issues:

    • The HIV-positive partner might focus on not infecting their partner. The HIV-negative partner may concentrate on taking care of the other person. This can cause a serious lack of balance in the relationship.

    • HIV can cause changes in the body. Anti-HIV medications may have unpleasant side effects. This might give the HIV-positive partner negative feelings about their body and their health. It may be difficult to feel attractive and have a normal romantic relationship.

    • Fear of transmitting HIV can cause an excess of caution. This might even stop all sexual activity.

    • Try to have open discussions about your desires, your fears, and your limits. Agree on ways of sexual expression that fit with the level of risk you are comfortable with. Talking to a sexual or relationship counselor can help.

    Reducing the Risks

    Antiviral medications (antiretrovial therapy or ART) control HIV infection very well.

    The good news about taking ART is how well it works. There is no cure for AIDS and ART won’t get rid of HIV infection, but it can help you live a full, healthy life.

    ART can also make it very unlikely that you will pass HIV infection to your partner. If you maintain an undetectable viral load, chances are good that you won’t pass your HIV infection to your partner. However, there are several important things to remember:

    • You have to take ART very regularly for it to work. Fact Sheet 405 has more information on adherence to treatment.

    • An “undetectable” viral load does not mean zero. It means there is not enough HIV in your blood sample to show up on the test.

    • The viral load test measures virus in the blood. It doesn’t tell you about virus in sexual fluids (sperm or vaginal fluids.)

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