The HIV+ relationship status dynamic (part II).

Up to half of HIV+ people in Sub-Saharan Africa are in relationships with HIV-negative partners. We tackle challenges faced by mixed-status couples.

The HIV+ relationship status dynamic

HIV+ relationships

In Part I of Relationship status: it’s complicated, you read that “serodiscordant couples [are] Africa’s largest HIV at-risk group”. (‘Serodiscordant’ refers to a relationship in which one member is HIV+ and the other HIV-.) According to the SA HIV Clinician’s Society, in sub-Saharan Africa “up to half of HIV-infected [people] in stable relationships have an HIV negative partner”. HIV serodiscordance is common.

People living with HIV are known to experience stigma and depression, and of course ill health, and often withdraw as a result of intimate relationships. But, “with the advent of ART, people living with HIV are able to live normal lives including having sex and the desire to have biological children.”  The quote below, however, illustrates the reality of a relationship for a serodiscordant couple.

Our basic human need to be sexual and intimate with others, regardless of HIV, may be affected by how we feel physically and emotionally. Our sexuality can also be affected by our own attitude, as well as by messages society gives us about the diversity of sexual practices. If your partner is HIV positive, she or he may have fears about the risk of infecting you through sex and you may also wonder about your level of risk of infection. Accurate information is essential to you both – including information about the level of risk associated with specific sexual practices.

Bringing this reality closer to home, these sobering facts come from the National Center for Biotechnology Information:

  1. Studies have found that in sub-Saharan Africa 10–25% of new HIV infections occur in HIV-discordant couples.
  2. The prevalence of HIV discordance among married and cohabitating couples in sub-Saharan Africa ranges from 3% to 20% in the general population, and 20% to 35% in couples in which one partner seeks to care for HIV-related conditions.

The reason why this relationship status is so complicated is certainly clearer now.

If you are the HIV-positive partner in a mixed-status relationship, here are some steps you can take to reduce your risk of transmitting HIV to your partner:

Antiretroviral therapy – stay on treatment

By reducing the amount of the virus in your blood and body fluids, the chance of transmitting the virus to your partner is reduced. Just remember that taking ART consistently and correctly is the key.

Listen to advice

Regular visits to your healthcare provider are critical to staying on top of the virus.

Always use condoms

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

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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.

Talk to your partner about 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.

Make sure your partner acts immediately if there’s been a possibility of exposure to HIV

If your partner has had anal or vaginal sex with an HIV+ partner without a condom or while taking PrEP, make sure your partner sees a doctor immediately. Their doctor should prescribe PrEP immediately to be taken daily for four weeks.

Get tested!

Encourage your partner to get tested at least once a year.

Beware STDs

Sexually Transmitted Diseases (STDs) can have long-term health effects negative effects on your health and can increase your chances of transmitting HIV to others.

If you read Part I of this article,, you may be thinking right now that these tips are awfully familiar. You’re right. These tips are almost identical to the tips for HIV+ people. Which make sense, doesn’t it? Staying safe is all about adhering to some common-sense rules and it applies to all of us, whatever our status.



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