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.



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

The HIV+ relationship status dynamic

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.

Relationships in this HIV and AIDS era.

Should HIV change the way you behave in relationships?

Dating and HIV. Both sides of the story.

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.