Dealing with HIV in your relationship
Dealing with HIV in a relationship can be stressful and quite a burden for both partners, however it is something that many couples have managed to do.

If your partner doesn’t know you have HIV, you may be concerned about how and when you are going to tell him. There are very good reasons for telling your partner you have HIV, not only because you could pass HIV on to him if he is HIV negative. If your partner knows you are HIV positive then he may well be able to give you the emotional support and understanding you may need in dealing with having HIV. If you haven’t yet told your partner you have HIV then we talk about this in the section on Disclosing Your HIV Status.

What if I got HIV from my partner?
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If you got HIV from your partner, it’s possible that he could be feeling guilty or angry that he infected you. He may well need your support and understanding just as much as you need his. Talking through how you are both feeling with each other is an important step in coming to terms with your situation, however it may take time. You may both be feeling different emotions and have different needs at first, so you may need to talk to someone you trust outside your relationship if it’s too hard for you to both deal with on your own.

"I’d been together with my partner for ten months when I was diagnosed with HIV. I knew he was positive, but it still came as a shock to us both when it happened. We were mostly safe when we had sex, so I suppose it was one of those stupid ‘one-offs’ we had when wrecked one weekend. Still, it was something that I’d been prepared for, but I wasn’t prepared for his reaction. He was devastated. He felt so guilty that he’d infected me and I ended up spending most of my time trying to help him through my diagnosis. When I needed to talk about how I felt he found it difficult, so I ended up talking to a close friend instead, and he provided the shoulder I needed until my partner felt more able to talk. I also found the internet useful, and found a couple of positive chat rooms where I got a load of useful advice and help from the other positive guys who were online. We’re ok now and both over the shock. I don’t know how we’d have lasted if I hadn’t found others to talk to at the time though." (Jim, 28) 

What if I got HIV from somone else?
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If you got HIV from someone other than your partner after you got together, how this affects you both may well depend on what rules you had for having sex with other men. If you hadn’t agreed to an open relationship then telling him you have HIV may well be much harder than if you had. This situation may be very difficult for him to deal with, and one that your relationship may not be able to withstand. You’ll need to give him time to come to terms with you having sex with someone else, getting HIV and the possibility and worry that you may have also passed it onto him. Remember, though, that even if you have had unprotected sex with your partner since you got HIV, he may still not be infected. However, since you know that you have HIV, if you continue to have risky sex without telling him, then you are likely to do more damage to your relationship. If you give him HIV without him knowing you are HIV positive you will also be leaving yourself open to prosecution, which we talk more about in the section on HIV Transmission and the Law.

It’s also possible that it was your partner who got HIV from outside your relationship after you got together, and then passed it on to you. If that’s the case then it’s possible that you could be feeling angry towards him for infecting you, especially if your relationship was supposed to be monogamous. He may not have even been aware that he was HIV positive. If you do feel angry and need to let off steam with someone, you could talk it through with a mutual friend, preferably someone who is also HIV positive, first.

If you are starting out in a new relationship or you’ve met someone who you are keen on and haven’t yet discussed HIV, trying to plan when and how to tell him you have HIV may not be easy. It may well depend on whether you have had sex with him yet and whether you used condoms or not. We talk more about this in the section on Looking for a Relationship.

Whatever your situation, having HIV in your relationship is something that is often best dealt with through each other’s mutual support and understanding. This, along with honest dialogue, can also help to make relationships stronger in the long run. You may be surprised how deeply you are both affected by HIV in your relationship. Talking things through will not only help you to understand what your partner needs, but will also help him to understand what you are going through, and what living with HIV means for you.

Although talking to each other is important, you may not both want to talk about HIV the same amount. Just as you wouldn’t want to be defined by your HIV status, you probably wouldn’t want your relationship to be defined by status either. Try not to immerse yourselves completely in talking about HIV and continue to do the things together that you enjoyed before and that made your relationship work. This will help you to both take your minds off what’s happening for a while and remind you of why you are together.

If you feel you and your partner need help in dealing with HIV in your relationship there are people who can help. You’ll find information about the support available later in the section on Relationship Support.

HIV can also have an effect on your sex life. Losing your sex drive or problems getting an erection can be a result of having to deal with the fact you have HIV, or caused by the stress of trying to deal with HIV in your relationship. You can find information and advice about this in the section on Positive Sex. 

Relationship with an HIV-negative partner
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If you have a relationship with an HIV negative man, this relationship is known as a sero-discordant relationship. Sero-discordant relationships are where one partner has HIV and the other does not.

It’s not unusual for HIV to be a big issue for both the negative partner and the positive partner in a sero-discordant relationship. There’s the possibility that you could pass it on to your partner, and this can be a real worry for both of you. Some men find this fear of transmission causes problems with the relationship, and sometimes the relationship may not be strong enough to cope with this fear.

However, sero-discordant relationships are not impossible. There are plenty of gay men in relationships where one has HIV and the other does not. It’s important for you both to be able to talk to each other about what HIV in the relationship means to you, and your fears and worry about passing HIV on.

Honest and open discussion about using condoms and the kind of sex you want, taking into account the different risks to your partner, will help you to develop a strategy for managing HIV in your relationship. Being on treatment and having an undetectable viral load will also greatly reduce the chance of HIV being passed on during sex. There’s no reason why you and your partner can’t have a healthy and fulfilling sex life and at the same time reduce the risk of passing on HIV to him.

It’s also worth talking to each other about what to do if you do have a slip-up; if a condom breaks or slips off, or if you forget the condoms in the heat of the moment. He could decide that if this happens you’ll both make sure he accesses PEP. PEP is a 28 day course of anti-HIV drugs that if taken within 72 hours of exposure could stop him becoming HIV positive. On the other hand he may decide that he doesn’t want to access PEP when a slip-up happens, and that he is willing to live with the risk. Whatever your strategy is it’s best to have talked about it beforehand so you both know what to do if a slip-up happens. You can read more about PEP on our Sex and Sexual Health pages.

"My partner was diagnosed with HIV 6 years ago. He got HIV from a man he had sex with outside our relationship. We always had an open relationship and so we had talked about the possibility that one of us could bring HIV into the relationship. When it happened it was still a big shock to both of us, however, but as we had discussed things beforehand we found that we could talk about how to manage our relationship and especially our sex life without any blame or fear of what the other may think. We didn’t use condoms for fucking before he was diagnosed, but since then we stay as safe as we can be. It’s just something that takes a bit of getting used to but reaching for the condoms and lube every time we want to fuck now seems second nature.
Six years on and I’m still HIV negative. We intend to keep it that way, and although it’s not always easy to be good we have managed not to let HIV get in the way of the love and lust we have for each other." (Adrian, 37)

If you have an open relationship with an HIV negative man, then talk to each other about your strategies for sex with men outside the relationship. If, for example, you’re getting used to using condoms together since you were diagnosed, the transition can sometimes get in the way of your sex life at first. It can be easy in situations like this to become complacent about condom use with men outside the relationship. However, most HIV negative partners of HIV positive men who then also become HIV positive get their HIV from someone outside the relationship. Make sure that he’s aware of this and talk about how important it is for him to continue using condoms with other men.

Relationship with an HIV-positive partner
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If you have a relationship with another HIV positive man, this relationship is known as a sero-concordant relationship. Sero-concordant relationships are where both partners have the same HIV status, either positive or negative.
If you are in a relationship with another HIV positive man, you may be thinking that since you both already have HIV you want to stop using condoms when you fuck. If you are in a monogamous relationship and don’t want to use condoms, it’s a good idea for you both to first get a sexual health check-up. This way you’ll be able to make sure that neither of you have another sexually transmitted infection (STI) such as hepatitis C or syphilis which you could pass on through unprotected sex.

Even if neither of you have any other STIs, there are still reasons why you may want to use condoms. If you have sex with men outside the relationship then there’s always the chance that one of you could pick up an STI from another man and then pass it on to the other partner. It’s a good idea for you both to have regular sexual health check-ups if you do have an open relationship, as this will help to ensure that you are looking after each other’s sexual health. If you don’t have sex outside the relationship you may decide to use condoms to avoid the possibility of re-infection. Re-infection is where someone with HIV is infected with a different strain of HIV from the one they already have. It’s possible that this second strain could be more virulent or resistant to one or more anti-HIV drugs. This could in turn reduce your future HIV treatment options. You’ll find information about this when we talk about protecting yourself in the section on sex.

You can get free sexual health check-ups at any GUM clinic. You can find your nearest clinic by going to GMFA’s London Gum Clinics section.

Your partner as a carer
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It’s not uncommon for partners of HIV positive men to assume the role of primary carer in situations where the HIV positive man is experiencing problems with his health.

Having your partner become your primary carer can be highly stressful for both of you. Emotionally it is likely to be hard for your partner to cope with seeing the person he loves in poor health, and switching between the roles of lover and carer may prove difficult for him.

He may have fears about your future which he doesn’t feel he can discuss with you. In this situation it’s important that he finds someone to talk to, maybe a close friend, so he gets the chance to release any bottled up emotions and fears about your situation.

If you are in poor health, having to rely on your partner can cause feelings of anger about losing some of your independence, and guilt for having to lean on him so much. Often in situations where one partner is also primary carer, both will have worries that aren’t discussed. There is support available for you and your partner if you are in this situation, but being honest and open with each other, or even with a close friend, about how you feel will help you to better cope with the stressful times.

"My partner hasn’t been well for a long time. He has severe pains in his hands and feet caused by peripheral neuropathy and this makes it difficult for him to get about or do much for himself at least half of the time. This has meant that I’ve found myself in the role of his primary carer when he’s in pain. Although I’m kind of used to it now it hasn’t been easy, and sometimes it isn’t still. As well as working full time I also do most of the shopping, cooking and cleaning so I don’t get much time to relax each day. This on top of watching the man I love in distress most days is very hard, and sometimes I really do struggle to cope. Having said all this, we do manage to get by, and despite everything we have been and are going through we are very happy together. However, I can’t tell him how much it affects me when I’m finding it hard going – I just couldn’t pile up that guilt on him when he’s already in pain. I have a lot of close friends who I can offload to and they give me the support I need when I ask, and without them I don’t know how I’d cope." (Adrian, 37)

If you do feel that you or your partner needs some help dealing with your situation, then you’ll find information about the support available in the section on Relationship Support.

If you are unable to work due to ill health, or need help with looking after yourself or getting about, then you and your primary carer may well be entitled to some state benefits. You’ll find information about these in the section on Work, Money & Benefits.

Ending relationships
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As we all know, relationships don’t always last. Often relationship break-ups are simply down to people growing apart; however, HIV can put a major strain on a relationship and sometimes be a major factor in the relationship ending.

If it’s a relationship where only one partner has HIV, fear of passing HIV on to the HIV negative partner can become too much of a burden on the relationship. This could be the HIV negative partner’s fears of getting HIV, the HIV positive partner’s fears of passing HIV on, or a combination of both.

It is possible to reduce the risk of this happening by making sure you always practise safer sex. Talking through your fears together and developing your own strategies to reduce the risk of transmission will help. However, there will always be a risk that it could happen, and slip-ups or condom failures can occur, so this risk, however much you have done to reduce it, can still sometimes be too much for a relationship to withstand.

If one of the partners in a relationship is in poor health, the strain of having to rely on the other partner and for him to assume the role of primary carer can also prove to be too much.

HIV can also affect your sex life, and this can eventually cause a problem with the relationship. If one of you is experiencing a loss of sex drive or finding it difficult to get or maintain a hard on, for instance, it’s possible that you may both start to feel that you are sexually incompatible. However, it may just be that HIV is affecting one of you so much that it is causing these issues with sex, and talking to the right people can often sort this out and get your sex life back on track.

Whatever the issues with your relationship are, there are people who you can both talk to for help, such as relationship counselling, sexual health counselling and carer support. However, even with all the help available, sometimes the relationship will still end.

If your relationship does end, and HIV was a major factor in the split, then there’s probably no point in either of you blaming the other. For example, if your partner could no longer deal with seeing you go through ill health then it’s not his fault that he couldn’t cope, just as it’s not your fault that you are experiencing health problems. If it is the end, try to accept that the relationship is over so that you can both move on, and understand that no one was at fault.

Image: Chris Jepson