In the UK over 100,00 people are HIV positive (HIV Aware website). Many of those that are HIV positive are in serodiscordant relationships. This means that they are in a relationship with someone who has a different HIV status, in the case HIV negative. There are many barriers to being in a serodiscordant (or mixed status) relationship, but also many opportunities for growing together and for having a stronger, more fulfilling relationship. In this week’s blog we explore a few of those:
One area that can cause anxiety in a serodiscordant relationship is sex. Some people who find out they are HIV positive stop having sex all together, whilst others enjoy a full and happy sex life. One of the main reasons that sex life can be affected is the concern about transmitting HIV. This worry can often be reduced through better knowledge of harm reduction and transmission routes. For example, something as straightforward as knowing that risk of transmission through oral sex is very low, having unprotected anal sex as a bottom is the highest risk, and knowing what PEP is can all help lessen concerns about having sex. Some couples also find that counselling and support groups can help alleviate some of the worries about HIV transmission (see below for support numbers).
Disclosing HIV status
One of the biggest challenges to being in a serodiscordant relationship for the positive partner is disclosing their HIV status to their sexual partner. This is difficult primarily because of worries about the HIV negative partner’s reaction. Some partners are supportive and understanding, but others may be angry and upset, especially if they are worried that they may have become (or at risk of becoming) HIV positive. The reasons to disclose or not are complex and vary from person to person and can be impacted by various overlapping factors such as age, culture, treatment, sexual behaviour, transmission understanding and knowledge. Although awareness that a partner is HIV positive can often be a shock, and in some cases can be difficult to deal with, increased understanding of transmission and treatment, and external support can often make disclosing ones status and moving on after disclosure easier.
The Plus One report published in 2011 (available to download here) showed that one of the prevalent themes in interviews with those in sero-discordant relationships is uncertainty. Uncertainty and fear about transmitting HIV, uncertainty about becoming HIV positive for the negative partner, uncertainty about consequences on sex life and uncertainty about the longevity of relationships following diagnosis. The main cause of uncertainty was described as the ‘lack of understanding about the nature, prognosis or infectiousness of HIV, or about how the other partner felt about the future of the relationship’ (p 2). The report recommended that one of the ways this can be tackled is through giving tailor-made written information about HIV prognosis and transmission to the partners of people diagnosed with HIV.
Serodiscordant or not?
Obviously, the information above is targeted at men who are knowingly in serodiscrodant relationships. Many individuals are in relationships with someone they think has the same HIV status, but who actually doesn’t. One of the main reasons for this is because of a lack of HIV testing. It is recommended to have an HIV test if you are sexually active about every 3-6 months. See here for information on the free, rapid, pop-up HIV testing we do across London and here for info on the NHS website of the nearest sexual health clinic to you.
For support contact:
Positive East (East London support) – 020 7791 2855
Firspoint (South London support) – 020 7160 0949
THT helpline (National) – 08451221200
GMI provide rapid HIV testing and HIV prevention outreach across London. Please see our calendar to see where we are this week.