Opposites attract, or so the saying goes. You might be type A and dating someone who’s super laid back, or maybe you’re an uber-organized person in a relationship with someone who loses their keys every day.
Different personality types can learn to get along, but can you still be compatible if your partner is HIV-positive and you’re HIV-negative?
These types of partnerships, called serodiscordant relationships, can feel scary for the person without HIV (“Will I get the virus from my partner?”) and stressful for the person with HIV (“Could I pass it to my partner?”). And any plans to have children can bring a whole other level of worry into the mix.
Years ago, serodiscordant relationships could have unwanted effects. Back then, the chance of passing the virus to an HIV-negative partner was high. But things have changed a lot.
If you’re in a serodiscordant relationship or getting ready to start one, here’s what you need to know to protect yourself and your partner.
A serodiscordant couple is one in which one partner is HIV-positive and the other is HIV-negative.
“Sero,” as in your “serostatus,” refers to whether you have antibodies to HIV on a blood test. Someone who’s seropositive has them, while someone who’s seronegative doesn’t. “Discordant” means your serostatus is not the same as your partner’s.
Other terms for serodiscordant couples are:
- mixed status
Any couple in which one partner has HIV and the other doesn’t — regardless of the partners’ sex, gender, or orientation — is serodiscordant. Marital status doesn’t change things. The only thing that matters is that you have sex with your partner somewhat regularly.
If you don’t know your partner’s HIV status or your own, now is a good time for both of you to get tested. Once you know, you can take steps to avoid transmission, if necessary.
“Undetectable” means the amount of HIV in your partner’s blood is so low that it doesn’t show up on blood tests. The way to get to undetectable status is to take daily antiretroviral therapy (ART).
If your partner’s viral load stays undetectable, there’s practically zero chance that they’ll pass the virus to you. When a person with HIV takes ART, their chance of transmitting HIV to their partner through vaginal or anal sex is close to zero. It’s not impossible, but it’s not very likely to happen.
Of course, your partner has to take the medication every day for it to work. If you’re not sure how consistently they take it, it never hurts to use a barrier method, such as a condom, just in case.
If your partner has been on ART for a while and their viral load is undetectable, then you probably don’t need to take a daily pill yourself. But if your partner just started taking ART or you don’t know how regularly they take it, PrEP could be good insurance against transmission.
HIV shouldn’t stop you and your partner from having children. But you will need to think about how you approach the pregnancy.
A pregnant person with HIV can pass the virus to their newborn at any point in the pregnancy. If the person is not taking ART, the chance of this happening is around 30%. But if they take ART, that number drops to just 2%.
If the partner assigned male at birth is the one with HIV, one option is to use a sperm donor. There’s also a technique called “sperm washing,” which separates the sperm from the semen (where the HIV is) to prevent the virus from passing to the baby.
Making sure that the partner with HIV has their viral load suppressed as much as possible before you try to conceive will give you the best chance of preventing transmission to the baby.
While the treatments for HIV have improved a lot over the years, some attitudes remain stuck in the past.
More than 40 years after the discovery of the virus, couples can still face stigma from friends or family members who worry about “catching” HIV from a handshake or hug. Some well-meaning but uninformed people may even try to break up serodiscordant couples.
Handling stigma from friends and family
If you’re dealing with stigma, you might want to keep your partner’s HIV status under wraps or avoid anyone who doesn’t understand or support your relationship. But there are other things you can do.
One is to change the script. People often fear what they don’t know. Print out information from the Centers for Disease Control and Prevention or from your doctor and give them a lesson on the truths behind HIV myths.
You can also reach out to people who do get it. An HIV support group or community organization is a good place to get advice on handling the less understanding people in your life.
Handling stigma from healthcare professionals
You’d think doctors would understand HIV, but stigma is a problem even in the medical field.
Stories still exist of doctors who put on double gloves or refuse to touch their HIV-positive patients during an exam.
Unfortunately, there’s no law that requires a doctor to treat you or your partner. But if one does deny you equal and compassionate care, you have options. You can file a complaint with your state department of health, or you can find a new doctor.
Lots of things can lead to breakups, from cheating to a lack of communication. HIV status doesn’t have to be one of them.
Serodiscordant couples can have it all: love, a great sex life, and a family. And while no one can guarantee you a blissful future, sticking to ART treatment and using other preventive measures can at least give you a safe one.