My partner is hiv positive

Contents

Question

Why did my partner test positive when I tested negative?

16 January 2018. Related: All topics, HIV transmission, Sero different couples.

My partner and I have been together for six years. He tested positive three years ago.

Automatically assuming I would be infected already we continued to have unsafe sex. I never went for a test until three years later in 2012.

He was beginning his treatment and wanted me to do the same, but when I went to my local clinic I tested HIV negative.

Can I trust these results or should I worry about testing HIV positive in near future? I’m so confused!

Answer

Answer: Angelina Namiba

It is very common for someone to still be negative even if they have not been using condoms with someone who is HIV positive. HIV is quite a difficult virus to catch, so your negative result is also related to good luck.

As your partner has just started treatment, the risk of transmission will already be much lower. Then, once his viral load becomes undetectable the risk is effectively zero..

The PARTNER study showed that treatment dramatically reduces the chance of further sexual transmission. For example, after 58,000 times that an HIV positive person had sex without a condom with an HIV negative partner, there were ZERO transmissions. This needed viral load to be undetectable on treatment.

This and other studies led to the U=U campaign (undetectable = untransmittable).

This guide to HIV testing and risks of sexual transmission includes more info on transmission risk. Also, the answer to Question 9 at this link:

If your partner in not on treatment or if he still has detectable viral load, then using condoms will make sure you stay negative. Another option is to talk to your doctor about PtRP, which is where you can take a pill that will protect you against HIV. The UK guide to PrEP has more info.

Note: This answer was updated in January 2018 and July 2016 from a question first posted online in July 2012.

25. How do I find support centers or support groups near me?

Each state has its own toll-free HIV and AIDS hotline, and Project Inform has the full list at ProjectInform.org/hotlines. If you call Project Inform HIV Health InfoLine (800-822-7422), you can talk to nonjudgmental people (in English or Spanish) who will listen to you, share their experiences, offer you accurate information about HIV, and help you navigate health care obstacles and talk to doctors about your concerns.

26. If for some reason I’m bleeding, do I need to worry about people who are helping me?

This probably depends on the situation, but often the answer is no. HIV is rarely transmitted in a household between family members (outside of sex and injection drug use, of course). And, if, for example, you get hurt playing football or duking it out at the gym, it’s “highly unlikely that HIV transmission could occur in this manner,” according to the University of Rochester Medical Center. “The external contact with blood that might occur in a sports injury is very different from direct entry of blood into the bloodstream which occurs from sharing needles or works.” The same goes for blood on a Band-Aid or a nosebleed or a cut finger, says Lisa B. Hightow-Weidman, MD, MPH, an associate professor of medicine in the Department of Infectious Diseases, University of North Carolina-Chapel Hill, and an expert for TheBody.com. “There is no risk of getting HIV from blood that has been sitting outside of a human body. Even if the was infected, HIV begins to die once it leaves the body and becomes unable to infect anyone else.”

One caveat: If you’re in a serious auto or other accident, the emergency medical techs who are helping you should be using universal precautions, but it’s always good for your own health to tell them you’re HIV-positive (it’s illegal for health workers to refuse you care based on your status, per the federal Americans With Disabilities Act).

27. How do I answer when people ask, ‘Can you get HIV from…’?

Start by telling them how it is not transmitted, since old myths die hard. Since the virus cannot survive outside the body, you cannot get it from toilet seats or shared cups or utensils. You can’t get it from kissing or from spit, since it’s not transmitted in your saliva. It is also not transmitted in sweat or urine. You can’t get it from a swimming pool, hot tub, sauna, mosquito or rodent bites, tattoos, or ear/body piercings. Only four bodily fluids are known to carry HIV in quantities concentrated enough to infect another person: blood, semen, vaginal fluids, and breast milk. According to the Centers for Disease Control and Prevention, it is one of these fluids from an HIV-positive person that must come in contact with a mucous membrane or damaged tissue, or be directly injected into the bloodstream (from a needle or syringe) for HIV transmission to possibly occur.

28. Is there a cure?

No. There has only been one “cured” patient who has continued to live HIV-free for more than half a decade: Timothy Brown, also known as the “Berlin patient.” He was cured via a bone marrow transplant that he received as treatment for cancer. Since his case a number of other people have been called cured, but those cases haven’t held up to scrutiny or time, with the virus reappearing in many individuals thought functionally cured. As David Margolis, head of the Collaboratory of AIDS Researchers for Eradication, explains, “Timothy Brown probably been cured, and that’s a wonderful thing. But there are close to 80 million people that’ve been infected around the globe over the last century. So one in 80 million is not great odds. What it is, is proof of a principle: that a cure is feasible. But I want to manage expectations and convey the reality about this whole cure expedition, and that is: It ain’t gonna happen fast.”

29. It’s been 30 years, why isn’t there a cure yet?

Dr. Rowena Johnston, vice president and director of research at amfAR, explains there are roadblocks to curing HIV and they almost all revolve around “reservoirs,” pockets of virus that persist in tissues and organs even after a positive person’s viral load has become undetectable. Antiretroviral therapy helps contain any new viruses that these infected cells produce, but the blueprint for making HIV remains within an infected cells’ DNA. If treatment is stopped, there is nothing to prevent those new copies from being made, and they can quickly spread unchecked. Therefore, in order to cure HIV, we need to first find the reservoirs. “Locating all the places where HIV is hiding in the body is a bit like finding a needle in a haystack. A particular body part—such as the brain or the gut—can harbor a reservoir of HIV. Particular cell types, including immune cells that are found throughout the body and are not limited to one place, can also be reservoir sites. We will not be able to eradicate or neutralize this latent virus unless we know exactly where all of it is.”

30. What will it take for a cure?

Jerry Zach, MD, of the David Geffen School of Medicine at UCLA explains that HIV seems capable of “going to sleep” in these reservoirs, and because it’s not reproducing, doctors can’t detect or treat it. In order to eliminate the virus, doctors need to find ways to activate those reservoirs and make them visible for treatment with “latency reversing agents” to give patients with HIV who are being treated with antiretroviral therapy. Whatever is used to make those hidden reservoirs “turn on” needs to avoid making undetectable patients sick. Once the virus can “be seen,” Zach says the next step is to develop treatments to clear those infected cells and remove the sources of HIV from the body. He says that should lead to “eradication of the infection,” but real life examples like the Mississippi baby suggest that even low levels of the virus can later rebound and restart the infection all over again. The Mississippi baby was born HIV-positive but began antiretroviral treatment at birth before later being off the medications and appearing cured. But then the virus came back. Any HIV cure, Zach explains, therefore needs to offer “some extra protection,” something that stays behind to kill the virus in case any of it remains hidden and later rebounds. Different researchers are working on different aspects of this multipronged approach and each year new discoveries put us one step closer to finding a cure.

Reprinted from HIVplus magazine

I’m HIV Positive And My Partner Is Not

How many times have you decided to quit dating? How many times have you squawked “I’m done with looking!”? How many times have you come out of yet another break-up and questioned whether you’ll be single forever? It’s true: the seemingly futile search for love has populated the minds of many for generations, and it doesn’t feel any easier in the swipe-it-and-see dating culture of today. The struggle is, indeed, real. But now imagine you are HIV positive. In a world that ensnares the mind in endless conundrums and countless column inches detailing all the things you’re doing wrong in your dating life, imagine adding an HIV positive status into the mix. Being HIV positive continues to carry with it endless layers of societal stigma. The basis for this stigma comes from a governmental and social negligence to educate the population about what HIV actually is, meaning all that’s left is ‘what you’ve heard’. And what you’ve heard, probably, is that HIV is a virus which you contract by having unprotected sex with someone who is HIV positive, and that if you get it you’ve done something wrong, you’ve made a bad choice, and thus received a death sentence. However, a more accurate account would be that, today, a positive HIV diagnosis is far more manageable than diabetes. Not to mention the availability of more advanced drugs; treatment that can often lead to undetectability (this is where your viral load becomes so low that you are no longer able to pass on the HIV virus to sexual partners, condom or no condom); as well as quicker, less painful testing methods which encourage more people to get tested and know their status. What is not manageable is the stigma attached to being HIV positive. For that reason, for World AIDS Day we’ve decided not to focus on the stats surrounding HIV but, instead, to explore something that is rarely discussed: sex, love, intimacy and being positive. These subtle conversations need to happen in order to humanise those who are positive or in serodiscordant relationships (where one person is positive and the other negative). Because those who are so often seen as sites of sexual danger, those who are so often reduced to being just a virus, are probably also seeking intimacy – just like you. Ilana, 34, UK “We met eight years ago, we were friends at first then started dating. He disclosed his status two years after we first met, and after we had started our relationship. We had a great friendship before and an even better relationship after. I already loved and trusted him when he told me, so although it was a shock, I knew I had not been put at risk, and to be honest I was more worried about him than me. “Some days I think it’s affected us loads – especially in the early days. It impacted our decision to have children, it made me nag about him taking his meds (despite him having 100% adherence long before he met me), I worried about him changing cat litter because of the germs (I don’t now!), I worry about his sugar intake, as well as life and travel insurance. But now, I go months without thinking about it. “We always use condoms and I have annual tests, but what’s important for me is attending my husband’s appointments with him, understanding his results. He tests undetectable, which means we could have unprotected sex safely if we wanted to, but neither of us have issues with condoms so we haven’t changed. We enjoy a great sex life, there’s nothing that we do differently that I wouldn’t do in any other relationship. “Once he disclosed his status to me we had a really open conversation about sex, which in some ways improved things because from there we felt more confident to talk about preferences, likes and dislikes. Essentially, we’re just us, in love and living our lives. We have the same problems as everyone else: money, work, ageing parents, disagreements about which sofa to buy next. HIV doesn’t define our relationship in any way.” Dan, 30, London “I was diagnosed with HIV when I was 22. I distinctly remember the doctor telling me what it all means with phrases that meant nothing to me – ‘CD4’, ‘Viral Load’, ‘Immune deficiency’, ‘disclosure’ – and I said in return: ‘Alright, alright – but can I still give blowjobs?’ I thought love would most definitely be off the cards. But now, I still give great blowjobs and I am in love with a magnificent man. It took about five years for me to drag myself off my self-imposed scrapheap of a life and realise that, if you’re going to be your own worst enemy, you’ve got to be your own best friend. So that’s when I acknowledged that HIV+ stigma was a societal problem, not my own. “Love is an art – and you often have to suffer for art – so try not to see the tough times as an absolute, but as alchemy for growth. Now, I enjoy sex much more because I know to take nothing for granted. When you’re 22 and your face gets slammed against the window of life with an HIV+ diagnosis you can get fast-tracked onto a deeper meaning of love and life. And when you gain clarity on what you love – whether that’s romantic love, friendship or the incredible history of HIV and AIDS activism that enabled us to make love in peace today – you will fight for it.” Juno, 50, London “When I first discovered my status over 20 years ago, I was told that I had AIDS and that I had six months to live. And at that time the stigma around HIV – and there’s still stigma – made you feel like you had toxic blood, and you had to somehow keep that in at all costs. So the last thing on my mind back then was dating or sex. But I’m now of the mindset where I don’t want to have to persuade somebody to fancy me, or to love, or to have quick dirty sex with me. I’m undetectable, why should I have to lay it on the line when I pose no risk? “And yet. I feel like it’s a part of currency: we have to convince people that we’re safe to sleep with. I have been on dates and told people that I’m HIV+ and they’ve gone completely ape-shit at me, and have told me to get off the dating site otherwise they’ll post photographs of me, and tell me that I should stop trying to infect people, when in fact I’m telling them that I have HIV – I’m obviously not trying to infect anyone. So there’s a notion of immorality that comes along with being HIV+. “Should it be my right to ask the questions? If everybody is, then I’m happy with that, but they’re not. As a trans woman that is HIV positive I need to be really cautious about things that other people might have. I mean, my immune system – although I’m undetectable – probably isn’t that great after 25-odd years of being positive. But it just feels like we are still in that situation of explaining who’s toxic, and virulent, and catching. “For goodness’ sake, let’s have the real conversation about bodies, desire, sex, and HIV. Sex is intimate, even the roughest, most casual sex is intimate, and to be denied that is hard. For me there’s always been this idea that we as HIV+ people are denied our intimacy, we are denied that space around us to explore it and allow someone into it. Because we are told that we have to be watertight, certainly in relation to sex. “You know there’s estimates that 19% of all trans women worldwide are HIV+. 19%. And yet hardly any research funding is dedicated to working out why. That speaks volumes about the lack of intimacy and care directed toward these people. We need to be talking about us as living, breathing, sexy, desirable people. I’m not somebody who should need to persuade people to be intimate with me because I’m undetectable. I’m somebody you should want to be intimate with because I’m fabulous. I do feel sexy now, but it’s taken an awful lot of years.” Luca and Riccardo, 33 and 34, couple, Rome Luca: “I didn’t disclose with my partner immediately. I never took the risk of unprotected sex (even if I was already undetectable) and I gave us time to know each other. I was so scared that this thing could have ‘buried’ my true self from him under tons of misconceptions and illogical, very deeply rooted fears. All my friends did not agree with my choice, they begged me to disclose my status for weeks. But I knew we were a great match, and I knew he wasn’t ready to hear it. When I finally decided it was time to pull the rabbit out of the hat he told me I had chosen for him and that that was deplorable. “My answer was: I actually gave you the opportunity to know me, and to see if I was worth it. Now you have the choice, now you know me and now you know if this thing is bigger than me or not. After months he confessed to me he probably wouldn’t have dated me if I would have told him straight away, and he was grateful I took that decision.” Riccardo: “At the beginning it wasn’t easy. As Luca says, he didn’t disclose his status until a few months into the relationship so when he told me I was surprised, upset, betrayed, and lost. With time and dialogue we got through it: he was great in guiding me through all this, setting up appointments with nurses and doctors to understand exactly what the risks were, and the kind of behaviour that should be avoided. “I suppose that, to a certain extent, this was the first tough challenge we had to go through as a couple, and he definitely set the precedent of what it means to be a loving and caring partner. I try to support him the best I can: for example, we have lived in different countries in the past four years because of my work, and I made sure that access to treatment and care would be issues that we both worried about. In that sense, we are in this together. I think he’s right when he says that his HIV status has very much marked his life and identity, and I very much cherish that identity and battle.” Luca: “It’s not easy for anyone to fall in love. But I don’t think an HIV+ person should look for love just in the HIV+ community. Being HIV+ is a struggle that can make you stronger, it obliges you to think about others in a way that many don’t, and it has really helped me to develop a deeper sense of empathy, for example, and many agree it makes you use your time with a voracity that you didn’t imagine before the diagnosis… and not because you’re sentenced to death, but because you have smelled it, even if just for a day.”

Dealing with HIV in your relationship

Worried about the transmission of HIV?

You might be worried about infecting your boyfriend and feel guilty about that in advance. The other way around, you might be worried about getting infected by him. Before you know it, that could put pressure on the sex you have together. Discuss your fears and doubts with each other. There is a good chance that you are both wrestling with the same ones.

How do you react as the HIV-negative partner?

You might be shocked to hear that your steady partner has HIV and you may need some time to get used to the idea. Or you might be angry for a while and scared that you might also be infected. The information below can help.

Some facts about HIV

If his viral load is not (yet) undetectable:

HIV will not be transmitted if you:

  • fuck each other with condoms
  • use plenty of lube
  • make sure no sperm or blood enters your mouth or anus.

If the condom breaks or slides off during fucking, we advise you, as the HIV-negative partner, to start a PEP treatment as soon as possible but within 72 hours at the latest to prevent HIV from establishing itself in your body.
If his viral load becomes undetectable thanks to the treatment with HIV medications:

  • There is hardly any chance that HIV will be transmitted.
  • Under certain conditions, the two of you could stop using condoms. The most important conditions, besides an undetectable viral load, are that:
    o the HIV-positive partner must not have any other STIs, since those could increase the chances of HIV being transmitted. With a monogamous relationship, you will keep HIV away.
    o neither of you has any damaged mucous membrane on your penis or anus (e.g. from a recent medical operation).
  • It is possible to grow old with HIV. People with HIV who don’t wait too long to get treatment have more or less the same life expectancy as otherwise healthy people of the same age.
  • HIV internists keep close track of the health of people with HIV. Someone who is HIV positive is likely to find out that he has some other health issue sooner than the average person in the Netherlands would.
  • An HIV infection will lead to few if any limitations in your life. Most people with HIV give their health a score of eight (out of ten) or higher.

You are always welcome to talk to the HIV nurse.

Even if you react in a level-headed way as the HIV-negative partner, you naturally might still have questions or concerns. You are welcome to visit your partner’s HIV nurse. They are there to answer your questions, too.

Is it difficult for you, as the HIV-negative partner, to continue using condoms?

You are now the only one in the couple who doesn’t have HIV. But your partner might well have sex with other HIV-positive men and not have to use condoms to prevent HIV.

Do you find it hard to always use condoms with casual partners? Talk about this with your partner. Look together for solutions that could help you continue to use condoms with other men.

“Undetectable”: Your Burning Questions Answered

July 5, 2018 | Reading Time: 5 minutes

  • Emily Land, MA

In 2013, BETA published an article about viral suppression and having an undetectable viral load. A lot has changed since the original article was published.

To keep us up-to-date, Barry Zingman, MD, the medical director of the AIDS Center at Montefiore Medical Center and professor of medicine at Albert Einstein College of Medicine joins us to answer our questions about what it means to be undetectable, the risk of HIV transmission, and more.

How do I know if my viral load is undetectable?

The only way to know if your viral load is undetectable is through an HIV viral load or HIV RNA test that your doctor or health care provider can do. You will need to have your blood drawn for this test, and the test will determine the level of virus in your blood that day. If the level of virus in your blood is below the limit of detection of the test, then we say your virus is “undetectable.”

If my viral load is undetectable, can I transmit HIV to other people?

Barry Zingman, MD

I’m very happy to say that we know the answer to this. If you are undetectable, and have been on HIV medications for at least six months, and you continue that treatment, the risk of transmitting HIV is effectively zero.

This finding has been well-established over the last six to seven years by multiple research studies. After studying thousands of couples, over many years, research has shown that if an HIV-positive person is on effective HIV medications for at least six months, is undetectable, and stays on their HIV medications, they will not transmit HIV to other people.

Does this apply to people having anal sex?

Yes. If a person living with HIV is taking HIV medication, and has been undetectable for at least six months, they will not transmit HIV to anal sex partners (and it doesn’t matter whether they are the top or the bottom).

We know this is true from research studies with thousands of episodes of people having anal sex, with many years of follow-up.

What about oral sex?

Unless there is blood in the mouth, there is no risk of HIV being transmitted during oral sex anyway. So if you are living with HIV, and are undetectable, you will not pass on HIV to a partner during oral sex.

If I’m undetectable, is there a chance my viral load will become detectable again?

Being undetectable does not mean that you are cured of HIV. There are three instances when your HIV viral load might come back and be detectable again.

The most common instances are so-called viral “blips.” Blips are when your HIV levels become slightly detectable, but at a very low level, and then goes back to being undetectable again. People may experience viral blips when they take their HIV medications every day. Viral blips are usually due to issues in the lab, such as some slight error in the test or in the test conditions in the lab. Occasionally they are due to a slight but true increase in the viral load due to a stress such as an illness or a vaccine. Viral blips, in which the viral load goes right back down to undetectable soon, are considered harmless. There is no appreciable chance that a person with a viral blip will transmit HIV to another person.

People also become detectable when they stop taking their HIV medications or take them only partially. It may take between a week to several weeks after stopping HIV treatment for HIV to become detectable again, but people will see the levels of virus in their body go up to detectable levels.

The least likely scenario for a person to go from being undetectable to detectable these days is if the virus in their body becomes resistant to the medications they are taking. (“Resistant” means the medications have stopped working against HIV.) This is very rare for people who take their HIV medications every day, because the HIV medications we prescribe these days (and at least for the last 10 – 15 years) are very powerful and control HIV very well if taken properly. Resistance is no longer something that is expected to occur, no matter how long a person is treated, as long as they take their medicine well.

What if I miss one dose, will my viral load become detectable again?

If you are undetectable, and have been taking your medications every day recently, your viral load will very likely stay undetectable even if you miss one dose. The HIV medications are so good these days that it can take a week or even sometimes up to several weeks or more for people’s viral loads to become detectable after medications are stopped.

Should an HIV-negative person with an undetectable, HIV-positive partner take PrEP?

People in this situation should make a decision about PrEP after learning about it, thinking about their own particular situation, and figuring out what they’re comfortable with.

Consider things like:

  • Are you monogamous with your partner?
  • Do you know if your partner is monogamous with you?
  • Does your partner share their viral load information with you? Or not?
  • Do you know if your partner is getting regular medical care? Or are you unsure about that?

The more uncertainty there is in answering these questions, the more I would suggest to the person that they consider PrEP. But if someone is in a monogamous relationship with one HIV-positive person, and that person has been taking HIV medications for at least six months and is undetectable, I’m not sure of any reason why they would need PrEP. But the more uncertainty there is, whether or not it’s uncertainty related to their partner’s sexual practice or to whether they are undetectable, I would recommend PrEP as an effective method of HIV prevention.

There is also sometimes a psychological benefit to being on PrEP. It can make people feel like they’re just adding a second layer of protection, and some people might feel better about taking PrEP for this reason.

Do I still need to use condoms if I’m undetectable?

HIV medicines (antiretrovirals) only prevents HIV transmission—they don’t prevent other sexually transmitted infections (STIs), either from you to others, or others to you. Condoms are still very useful, especially if you’re having sex with multiple partners or in situations when you don’t know if your partner could have a detectable HIV viral load or might have an STI. I do recommend that people strongly consider using condoms—but it’s often for the other STIs or due to an unknown HIV status of their partners.

What does “Undetectable equals Untransmittable” (U=U) mean?

U=U is the name of a public health campaign that has really taken off in the last year and is accepted and endorsed by organizations worldwide. It shares the message that people who are undetectable do not transmit HIV to other people.

This campaign promotes key medical information that is important for people living with HIV to know, but it is also an important concept that reduces HIV stigma in the community. The phrase really encompasses an idea that people who are living with HIV can be free from HIV stigma, and can live their lives more fully, with less fear, worry, and inhibition.

  • Emily Land, MAEmily Land is the editor-in-chief of BETA blog and content marketing manager at San Francisco AIDS Foundation.

Living with HIV when one partner is positive and the other is negative

November 2012

Two months after Maripaz Callejas’ husband died of AIDS, she was diagnosed with HIV. One doctor told her that she would be dead within five years.

In Maripaz’s home country, El Salvador, many new HIV infections occur as a result of unprotected sex between couples who are married or living together. WHO estimates that globally as many as half of all HIV-positive people in long-term relationships have HIV-negative partners – forming what are known as serodiscordant couples. It is estimated that half of people living with HIV still do not know that they are infected, and, like Maripaz, many people in relationships do not know their partner’s status.

Couples should get tested together

PAHO/Kathya Jovel

That is why WHO recommends that couples get tested for HIV – and counselled – together. Receiving voluntary HIV testing and counselling as a couple means that both partners get tested together, receive their results and share their status with the support of a counsellor. A range of prevention, treatment and support options can then be discussed and decided upon together.

Maripaz is now married to Moises Marinero. Moises was aware of Maripaz’s HIV-positive status from the beginning. Maripaz was reluctant to start a new relationship at first, but a counsellor told her that it was safe to have sex, provided she always used a condom. She has been on HIV medication, antiretroviral drugs (ARVs), since 2002. Today, she remains healthy and Moises is still HIV-negative.

Maripaz was fortunate that Moises knew that she was HIV-positive and how to protect himself.

Living together as a serodiscordant couple

CDC Zambia/Karrin Parker

Life was initially tougher for Godfrey and Paulina Mtonga of Lusaka, Zambia. The couple have now been married for 32 years. They have 11 children and 8 grandchildren. In 1994, they went for HIV testing together. Godfrey was positive and Paulina negative.

“The first week was very bad for us,” Godfrey recalls. “The counsellor came to visit us the very next day.” The counsellor kept coming, and the couple decided to stay together. They continued to have a sexual relationship, using condoms from a nearby clinic. Godfrey started taking antiretroviral treatment in 2002. Pauline has remained HIV-negative.

Godfrey Mtonga’s advice to everyone is to get tested. “If you are positive, love each other and take your medicine at the right time. We have lived with our status as a discordant couple for the past 18 years because we support each other.”

Some countries—such as Kenya, Rwanda, Thailand, Zambia and others—have already introduced HIV testing and counselling for couples with a view to helping them support one another. Couples testing can be provided as part of pregnancy care or other health services, in peoples’ homes and as part of outreach testing in communities, as well as in voluntary testing and counselling sites.

New guidance on couples HIV testing and counselling

In addition to correct and consistent use of condoms, counsellors may suggest that the HIV-positive partner take antiretroviral drugs, regardless of his or her immune status. Studies show that this can both keep the positive partner healthier for longer, and reduce the risk they will pass the virus to their loved one. This finding prompted WHO to issue new guidance on couples HIV testing and counselling in April 2012 – including antiretroviral therapy for treatment and prevention in serodiscordant couples.

In addition to Zambia, which has recommended early ARVs for the positive partner in a serodiscordant couple since 2010, other countries—including Canada, China, Kenya and many in western Europe—currently recommend or are considering the use of ARVs to reduce HIV transmission in serodiscordant couples.

Being young and HIV positive

FAST FACTS

• As you get older, you’ll probably want to manage your own health, care and treatment but just because you’re becoming an adult doesn’t mean that you’re meant to ‘know it all’.

• Remember, it’s your choice as to when, where and how you tell people about your HIV status.

• You might benefit from joining a local support group of other young people living with HIV to share your feelings and experiences.

• Living with HIV shouldn’t stop you from having fulfilling relationships and a healthy sex life when you’re ready.

Whether you’ve only recently found out you have HIV or you’ve grown up knowing you have HIV, being a young person living with HIV can be particularly difficult.

Your teenage years are a time of great change – your body develops during puberty, and it’s often very emotional. It can be an intense and exciting time, but also it can feel difficult to cope with everything.

You may be finishing school and taking exams, and you’re probably thinking about your future. This is also a time when many people have their first relationships.

Taking more responsibility for your own health

Whether you were born with HIV and diagnosed at a young age, or diagnosed more recently, perhaps in your early teens, it’s likely that one of your parents or a guardian has helped you to take your treatment at the same time each day.

As you get older, you’ll probably want to manage your own health, care and treatment. And eventually, your healthcare will be transferred to an adult clinic, and this can feel like a big change.

Just because you’re becoming an adult doesn’t mean that you’re meant to ‘know it all’. You’ll still need support from family and friends, and you can ask your healthcare professional about any aspect of your health at any time.

There may be questions you want to talk about with them without anyone else being present, such as having sex.

Think about what you can do to remind yourself to take your treatment, and to manage your appointments. Setting an alarm is good – you could also keep your drugs in a pill box with the days of the week on it.

Telling your friends

Making a decision about whether or not to tell your friends (also called disclosing or sharing your diagnosis) about being HIV positive is different for everyone. Some people are open about it – perhaps you’ve grown up with it and everyone knows, and it’s not a big issue for you. For others, fear of rejection, bullying or gossip makes telling people really difficult.

Remember, it’s your choice, and you don’t have to tell people if you don’t want to. You may decide that it’s just not the right time, and that’s fine.

You may find it helpful to get to know other people in the same situation. There are support groups and activities for young people living with HIV, and these can provide good opportunities to find out about how other people are coping.

If you want to tell someone, or a group of friends, then it’s good to think about how you tell them. Think about how they might react, and the kind of questions they’ll have. Think about when and where, so you won’t be interrupted or rushed… and think about how you’ll feel afterwards.

Having relationships

You may worry that you can never have a relationship, or sex, or that you won’t be loved. None of these things are true – people living with HIV fall in love, have sex, have fulfilling relationships, marry, have children (without passing on HIV) – all the things that people who don’t have HIV do.

When you first meet someone, it can be really exciting and it can be intense, as you get to know each other. Starting a relationship with someone who doesn’t have HIV (also called a mixed-status relationship) raises questions. When should you tell them that you have HIV? How will they react? How can you have sex without passing it on? How do you explain what it means to be undetectable and about PrEP?

Deciding how and when to tell a partner involves a lot of the same thinking as telling a friend, and more. For example, they may want to know details that you’re not ready to talk about such as who your previous sexual partners have been and what you did with them.

Remember that it’s your choice how much to tell them and when. You may want to avoid having a conversation, but bear in mind that the longer you put it off, the more upset they may be that you didn’t tell them sooner.

It’s not that bad and there are times when you forget you have HIV. Eventually, even when you remember you’re positive, it’s no longer an issue.

– A few words from someone who has been living with HIV for nearly 20 years

Having sex

If you’re going to have sex, using external (or male) condoms or internal (or female) condoms correctly is a very effective way of preventing HIV, sexually transmitted infections (STIs) and unplanned pregnancy.

Many clinics provide free condoms and other contraception, as well as confidential information and advice. There are other ways of preventing unplanned pregnancy, including the contraceptive pill, implant and injection (for women).

If you’re taking HIV treatment and it’s keeping the level of HIV in your body (viral load) very low, the risk of passing it on is much lower. If you’re undetectable you’re untransmittable.

It’s important to tell your healthcare professional if you’re taking HIV treatment and contraceptive drugs together, as some antiretrovirals interact with them and make the contraception less effective.

Sharing responsibility for safer sex

Talk to your partner before you have sex so that you can share the responsibility for having safer sex. If your partner knows about HIV, it can make it easier to talk about using condoms.

Having HIV shouldn’t stop you from having great sex – you have just as much right to a fulfilling and healthy sex life a person who doesn’t have HIV – but don’t feel that you have to have sex just because your partner wants to. It’s up to you to decide when you’re ready for sex – it’s your choice and no one else’s.

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Reader’s Lounge

Photo; Courtesy

I have been dating this lady for about a year and we had purposed to remain celibate until we get married since we are both virgins. A few months ago, we were attacked by a gang of thugs who beat us up and raped her in my presence. She is now HIV positive and now we have been advised to only have protected sex for obvious reasons. I want a family but it now seems almost impossible to start one with her. This realization has taken a toll on her since the mistake was not hers. I love her but I also want to be happy in my life. Please I desperately need your advice…{Vincent}

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Your Take:

Vincent I also agree with you and wish to add that no one is to blame for this. She needs to accept what has happened and continue with life and in so doing, let you go. Remember you have only one life and you don’t want to spend it with someone who puts you at risk. She can get some counselling to help her along but remember life has to go on.

{Cidni Cinite}

We have discordant couples living happily and even raising families. Seek further advice from a counsellor also about the other techniques of bearing children. There are many ways but also remembering to reduce chances for mother-to-child transmission. Stay with her because it was not her desire to be HIV+.

{Andrew Chaplin}

Vincent, I know it is hard to end this relationship but you know the consequences of having sex with a person living with HIV. There is no way you will have a family with her without having unprotected sex so you either choose between saving your life, and living a happy life or having a family with her and living a miserable life.

ALSO READ: Kobe and Vanessa Bryant’s love story – and how it nearly crumbled before it began

{Ojou Robert – Koyonzo}

Despite all the frustrations, life must go on. Support her in every way you can, show her that you love and care for her and that you appreciate and treasure her just as she is.

{Calvin Queens}

A real friend does not walk away when the other is in trouble so it would be good to stand by her. Anybody can be a victim of this, so do not blame her. However, remember that there are discordant couples out there and they live happily and bear children just like any other couple. Being positive is not the end of life brother. Give her a chance to live her dream of becoming your wife.

{Ouma Ragumo, Sifuyo}

Counselor’s Take:

ALSO READ: Inside Kobe Bryant’s adorable marriage to Vanessa and sacrifice he made to avoid pre-nup

Vincent, two wrongs don’t make a right. What happened to her was unfortunate and you should be there for her. However, putting yourself at risk just to please her is not a show of solidarity and she ought to understand this better than anybody else. Presently, the most important thing is for you to remain negative.

Being HIV positive implies that you should not, at any one time in your life, engage in unprotected sex with her. While this may be OK for short term relationships, it can be rather strenuous in a marriage situation.

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Many couples have actually found themselves in situations where one is positive and the other is negative even after prolonged periods of unprotected intercourse. Even in such instances, they are advised to have protected sex from then henceforth to safeguard the other partner as well as to reduce chances of re-infection.

This situation will have a heavy bearing on your future being that you already expressed a genuine wish to have a family. To remain safe, this would only happen if you both agreed to adopt children and have unprotected sex your entire life. I doubt that this is a sustainable way to maintain the relationship since you will always feel short-changed.

Bad things happen and more so, they happen to good people. However, it would not be right to compromise your entire future because of one sad thing that happened. The situation usually works better when both parties are positive thus the logic of having unprotected sex always is quite clear to both parties.

Sometimes people have to move on and hope that everyone will one day find what they are looking for. One way or the other, everyone will find what they are looking for or at least something similar to what they were looking for.

This, therefore, calls for you to weigh the facts of the matter as they are and make a decision. Remember, while we should always consider the well-being of the other person first, your primary responsibility is to yourself then you may consider others. {Taurus}

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