Dating & Living with HIV
'It’s complicated' does not quite describe the apprehension that HIV evokes among people who are in a relationship. Your HIV status raises an array of questions: How do you tell your partner about your status? Is sex still possible? How do you keep your partner safe? Will your partner stay after telling him the news?
Oftentimes we think of relationships as being both romantic and sexual. But we also know of some relationships that are purely sexual; “fuck buddies” or “no strings attached”. Then there are other types of relationships that were once sexual but evolved into companionship, friendship or other forms of non-sexual intimacy. And there are many other types of relationships that people have defined for themselves.
All of these different types of relationships can be viewed as spaces where we can exchange support, love and intimacy at varying degrees. What is common among all relationships is that they require effort and nurturing from everyone involved.
HIV status is one of many factors that affect the dynamics of our relationships. Other factors include our personalities, family histories, background cultures, the surrounding environment and our lived experiences. For some men, the HIV status of their partner is not an issue; for others it is a crucial factor. But regardless of HIV, everyone has a right to fulfilling love life and an enjoyable sex life.
Support for You & Your Partner
An announcement of an HIV-positive diagnosis within a relationship can be a challenge for anyone. Some people have struggled to find the right time to disclose their status to their partner. Others have been open about their status with their partner from the onset and found their partner to be a significant source of support. Only you can decide the strategy that works for you.
Sometimes when we disclose our status to our partner we inadvertently become our partner’s HIV counselor and educator. This might be challenging if you yourself are in need of support. In these cases you and your partner might consider seeking assistance and advice outside the relationship. Friends, counselors, and support groups for people living with HIV (PLHIV) have proven to be invaluable for many couples.
When discussing HIV within your relationship it is likely that your partner(s) will need to go for an HIV test and be tested regularly thereafter. You will also need to discuss any changes that need to be made to your sexual practices so that you can protect each other.
If it turns out that your partner is also diagnosed HIV positive this outcome will naturally bring up a range of emotions that you will both have to deal with in addition to the health implications. In cases such as this we advise the people involved to seek assistance from a trained HIV counselor so that the needs of everyone in the relationship can be addressed.
1. Monogamy & open relationships
There may come a time when you need to discuss your relationship boundaries in relation to sex with your partner. Many people have introduced creative solutions to keep their relationships fun and sexually satisfying for both parties.
Some relationships are strictly monogamous, only allowing sex within the relationship, while others have opened their relationships to the possibility of sex with people outside the relationship. There is a vast spectrum between monogamy and open relationships and many people’s relationships are somewhere in between.
Only the people involved in the relationship are in the best position to determine the rules (or lack thereof). What works for other people may not work for you. You can avoid feeling that you need to live by the rules and expectations of people by keeping an open and regular dialogue between you and your partner where you can discuss how to nurture your relationship.
Is the ongoing relationship more important than being sexually monogamous? If so, for men in open relationships, understanding how to avoid or reduce risks of other sexually transmitted infections is crucial. Talk to your doctor about how to manage such risks.
2. You're positive and your partner is negative
A sero-discordant relationship – a relationship where one partner is HIV positive and the other is not.
Every relationship has to find a way to create harmony among the differences of the people involved. A relationship where we are HIV positive and our partner is HIV negative may be challenging, but that does not spell the automatic end of any relationship.
Trust is essential, and therefore you should seriously consider the issue of disclosing your status. If you think disclosure could lead to violence or rejection, or if you feel you just need someone else to talk to, find a counselor or support group.
The fear of transmitting HIV is an important consideration, but the responsibility of prevention is shared and does not fall solely on the shoulders of the people living with HIV.
Talk to your partner about getting tested regularly. Discuss safer sex practices and how both of you can minimise risk.
3. PrEP (Pre-Exposure Prophylaxis)
Talk to your doctor about prevention strategies such as Pre-Exposure Prophylaxis (PrEP).
PrEP is a recently scientifically proven prevention approach where an HIV-negative, sexually active individual takes antiretroviral medicine regularly to reduce the risk of infection.
PrEP is designed primarily to combat HIV and therefore it is most effective at maintaining sexual health (and preventing other STIs) when combined with consistent condom use with lubricant and regular check-ups to screen for STIs.
Many community groups are advocating for PrEP to be more widely available across Asia. Find out more information about PrEP from Adam’s Love in Bangkok.
4. PEP (Post-Exposure Prophylaxis)
Post-Exposure Prophylaxis (PEP) is a 4 to 6-week course of antiretroviral treatment to reduce the risk of infection. PEP was originally designed as a response to accidents in clinics and hospitals among healthcare workers who may have been exposed to HIV while on the job.
However, the World Health Organization now has guidelines for the use of PEP in cases where people may have been exposed to HIV during sex with a known to be living with HIV.
In order for PEP to be most effective, it must be administered as soon as possible (within 72 hours) after possible exposure to HIV. PEP does not work against other sexually transmitted infections (STIs).
PEP is not as effective as consistent and correct use of condoms and lubricant during sex to prevent the transmission of HIV and other STIs, therefore it is usually considered a second-line measure if a condom breaks or slips, for example.
Acknowledgement: This information has been adapted from the “Next Steps” booklet with permission from the Australian Federation of AIDS Organisations (AFAO)