The HIV+ relationship status dynamic (part I).

There are 6.4 million HIV+ South Africans. 1 in 5 people living with HIV in the world are in South Africa. Find out what this means for relationships in our country.

The HIV+ relationship status dynamic

HIV+ relationships

Deputy President Cyril Ramaphosa acknowledged the sorry state of HIV in South Africa when he opened the Seventh SA AIDS Conference on 9 June: “Our country has more than 6.4 million people living with HIV… More than 1 in 5 people with HIV in the world live in our country… We have about 450,000 new HIV infections […] each year.”

With so many people suffering from HIV what does this mean for relationships in our country? Stats SA tells us in their report on marriages and divorces that in 2013 there were over 170 000 civil marriages, civil unions and customary unions registered. Marriages are decreasing and civil unions are increasing, but regardless, it’s still a high number of committed relationships that are being formalised each year.

A large proportion of the 6.4 million HIV+ people in South Africa are conceivably in relationships. And in all likelihood, a large proportion of these relationships are conceivable with HIV- people. Dr Susan Allen identified “serodiscordant couples [as] Africa’s largest HIV at-risk group”. ‘Serodiscordant’ refers to a relationship in which one member is HIV+ and the other HIV-. There are a number of terms that refer to this type of relationship:

  • Discordant.
  • Serodivergent.
  • Magnetic.
  • HIV-positive/negative.
  • Serodifferent.

For these couples, the risk of infection is obviously of grave concern. These tips below from are useful for the HIV- partner when it comes to reducing the chance of becoming infected and enjoying a healthy, long-term relationship:

Encourage the use of antiretroviral therapy

If your partner takes their ART medication as advised, their viral load will decrease as will the chance of transmitting the virus.

Always use condoms

Use a male or female condom correctly to prevent the transmission of HIV.

Choose less risky sexual behaviours

If you’re not swapping bodily fluids, there’s no risk of getting HIV. Oral sex is safer than anal or vaginal sex while anal sex is the highest-risk sexual activity for HIV transmission.

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Take pre-exposure prophylaxis (PrEP)

PrEP is a pill that contains two medicines that are also used to treat HIV. By taking the tablet every day it can offer good protection along with other prevention methods like condoms.

Act immediately if you think you’ve been exposed

If you have had anal or vaginal sex with an HIV+ partner without a condom or while taking PrEP, see a doctor immediately. Your doctor should prescribe PrEP immediately to be taken daily for four weeks.

Get tested!

You should be getting tested at least once a year, although your doctor may suggest more frequent testing if you’re in a relationship with an HIV+ partner.

Beware STDs

Sexually Transmitted Diseases (STDs) can have negative effects on your health and can also increase your chance of getting HIV. Both you and your partner should get tested and treated for STDs especially if either of you is sexually active outside the partnership.

Keep an eye out for Part II of Relationship status: it’s complicated for tips for the HIV+ partner.


We all have questions.

Below are some of the answers to the most common questions around HIV. 

What is usually the first sign of HIV?

After becoming infected with HIV, most patients only experience moderate flu-like symptoms. Typically, the illness is sudden in onset and is characterised by fever, swelling of the lymph glands, a measles-like rash all over the body, ulcers in the mouth and sometimes on the genitalia.

What are the 4 stages of HIV?

  • Stage 1: Infection – Exposure to infected bodily fluids.
  • Stage 2: Asymptomatic – HIV quickly spreads and the patient becomes seropositive for HIV antibodies.
  • Stage 3: Symptomatic – The immune system is now engaged in a constant battle with the rapidly replicating virus.
  • Stage 4: AIDS – At this stage, the patient’s CD4+ count is 200 cells per mm3 or less.

How soon can HIV be detected by a blood test?

No test can detect HIV immediately after infection. The time between initial infection and a detectable viral load is called the window period. It can take anywhere from 2-12 weeks to after exposure, to detect whether you are HIV-positive or not, depending on which testing method is used.

How long does it take to show symptoms of HIV?

Following initial infection, there is a period of intense, unchecked viral replication that occurs. It usually takes 2 to 4 weeks after infection and can last about 1 to 2 weeks, after which there tends to be a slight recovery, and the infected individual is considered to be seropositive for HIV antibodies.

How is HIV transmitted?

HIV is transmitted from one person to another through the exchange of body fluids. The main method of transmission in South Africa is through unprotected sexual activity.

Does HIV test affect life insurance?

Being HIV-positive can affect standard life insurance policies, particularly if your status changes from HIV-negative to HIV-positive within a particular age range. That’s why AllLife covers all lives. Your HIV status doesn’t prevent you from getting cover with us.

Can HIV-positive women have children?

Yes, HIV-positive women can enjoy healthy pregnancies and give birth to healthy HIV-negative babies, through the Prevention of Mother to Child Transmission (PMTCT) programme. PMTCT has been highly effective in reducing the HIV transmission risk to under 1%.

Related articles

Relationships in this HIV and AIDS era.

Should HIV change the way you behave in relationships?

Dating and HIV. Both sides of the story.

When non-adherence to ARVs is a risk to your health.

HIV treatment

When to start Antiretroviral treatment and the reasons behind why you should not delay treatment.

How to stay negative when at risk of becoming HIV+.

How can the spread of HIV be prevented?

How to take the relevant precautions and prevent transmission against the HIV virus.