WHAT ARE THE SPECIAL ISSUES FOR MIXED COUPLES?
REDUCING THE RISKS
USING A CONDOM
OTHER WAYS TO REDUCE RISK
IF YOU ARE EXPOSED TO HIV
HAVING CHILDREN IF THE MAN HAS HIV
HAVING CHILDREN IF THE WOMAN HAS HIV
Couples with one person who is HIV-positive and one who is HIV-negative are sometimes called “serodiscordant” or “mixed serostatus”. “Sero-” refers to blood serum. “Serostatus” refers to whether someone has HIV infection or not.
HIV isn’t the first topic that comes up when most couples start dating. You may not know the HIV status of your partner. You might not even have been tested yourself. It can be very difficult to talk about HIV status. See fact sheet 204 for some ideas.
People in mixed-status relationships face all the same things as other couples. But there are some extra issues:
Try to have open discussions about your desires, your fears, and your limits. Agree on ways of sexual expression that fit with the level of risk you are comfortable with. Talking to a sexual or relationship counselor can help.
Antiviral medications (antiretroviral therapy or ART) control HIV infection very well. Fact sheet 403 has more information on ART.The good news about taking ART is how well it works. There is no cure for AIDS and ART won’t get rid of HIV infection, but it can help you live a full, healthy life.
ART can also make it very unlikely that you will pass HIV infection to your partner. If you maintain an undetectable viral load (see fact sheet 125,) chances are good that you won’t pass your HIV infection to your partner.
However, there are several important things to remember:
Even with all these warnings, it is very rare for someone who is taking ART and has an undetectable viral load to infect a partner.
It is rare for a partner with an undetectable viral load to transmit HIV. However, it still makes sense to take extra steps such as using a condom (see fact sheet 153.) Condoms are very effective at preventing the spread of HIV. They must be used correctly, every time you have sex. If you can get used to using condoms, you can relax and enjoy yourselves more during sexual activity.
If a condom breaks, or if you forget to use one, anti-HIV medications might prevent transmission. Talk to your doctor about PEP, “Post-Exposure Prophylaxis” (See fact sheet 156.) This has not yet been proven to avoid transmission between sex partners. Do not just take a few doses of your partner’s medication! That might not be the right treatment. For PEP to work, it must be started very soon after exposure to HIV. Discuss PEP with your doctor in advance so that you know what your options will be in case something happens that exposes the negative partner to HIV.
Recent studies show that it is possible to "wash" the sperm of an HIV-infected man so that it can be used to fertilize a woman and produce a healthy baby. These procedures are effective but very expensive. A recent cost estimate was about $10,000, and medical insurance will probably not cover the cost. It can be very difficult to find a place to have sperm washing done.
Without treatment, up to 35% of pregnant women with HIV can pass the infection to their newborns. With proper treatment, the risk of passing HIV to newborns drops to 2% (see fact sheet 611.)
Artificial insemination, a simple procedure, places the man’s sperm into the woman’s vagina. This allows pregnancy without exposing the man to HIV.
If a woman with HIV becomes pregnant, she should be very careful to stay healthy during pregnancy. Be sure to discuss pregnancy with your health care provider, preferably before becoming pregnant. Your provider will help you with the treatment you need to reduce the chance your baby will be infected. Also, avoid breastfeeding a newborn. This can transmit HIV. Fact sheet 611 has more information on pregnancy for HIV-positive women.