Practising safer sex in mixed status relationships
It starts with full disclosure knowing each other’s status. This is an important foundation for an honest, loving and supportive relationship. If a person can’t take you for what you are, then that relationship wasn’t meant to be. You are better off without them!
The possibility of HIV infection is a constant reality in mixed status couples. In the beginning, sexual intimacy may seem uncomfortable and overly cautious because of fear of transmission. It may take time and with open communication about limits, fears and desires, these initial fears can be overcome. Talking to a counsellor can help.
Standard protocol is to advise mixed status couples to practice safer sex i.e. using a condom correctly and consistently. But truth be told, that it is not always easy. There may be passionate occasions when you get caught up in the moment and hope this one time you will get away with it. It is harder still if you had been practising unprotected sex before disclosing your HIV status.
There could be religious obligations. One of the partners could be allergic to latex condoms. What about having children? Who knows maybe you want to be infected so that you and are partner can live a positive life together (I have heard of this before). The reasons are myriad and compelling (or not) but are they alternatives for couples who don’t want to use a condom?
Treatment as prevention is a viable option. For people with HIV being on ARVs lowers the risk of transmitting infection to an HIV negative partner. ARVs help lower viral load in body fluids reducing possible transmission. However, there is still a risk that transmission can occur. That’s why using condoms is the best and safer option.
Conceiving a baby is possible through a safe and successful pregnancy while preventing HIV to the negative partner. It is important to talk to a health professional about your desire to have children so that they can discuss options.
If the woman is infected there a “low-tech” options which involve injecting partners sperm using a needless syringe during the time of ovulation and then taking ARVs to prevent mother to child transmission. For infected men, they are “high-tech” options such as sperm washing (not available in Malawi) and “low-tech” options such as using treatment as prevention.
Both partners in a mixed status relationship should be supportive, understanding and openly communicative in order to reduce the risk of HIV transmission as well as in considering the options for conception.
