Dating someone who's HIV-positive

Originally Published: February 16, 2001 - Last Updated / Reviewed On: March 8, 2013
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Dear Alice,

I recently began dating a guy who is HIV positive. I know how it is transmitted and the risks involved, but I was wondering if there are any statistics out about being infected in my similar situation. How high are my chances of contracting it if we are careful?

Dear Reader,

There is no way for a sexually active person to be 100 percent certain that s/he is protected from HIV infection or any other sexually transmitted infection (STI). However, there are many ways to significantly reduce risk of transmission, even for an uninfected person in a sexually active relationship with someone who is HIV-positive.

Many studies have been conducted on serodiscordant couples, meaning that one partner is HIV-positive and the other is HIV-negative. Growing evidence suggests that as HIV medicines become more efficacious, HIV-positive individuals taking antiretroviral medications are significantly less likely to transmit the virus to a sexual partner than someone not taking medication. In fact, in a study of almost 3,000 monogamous serodiscordant couples, it was found that with the use of antiretroviral therapy, only 3.4% of sexually active couples would transmit HIV from the infected to uninfected partner over a period of 100 years. Risk is reduced even further when the following qualifications are met:

  • The HIV-positive partner complies fully with doctor’s instructions for antiretroviral medications and is evaluated regularly by her or his treating provider. This is crucial, because even a temporary slip-up in the HIV-positive individual’s medication regimen may facilitate rapid virus replication, thereby increasing viral load.
  • The HIV-positive partner’s viral load has been undetectable for at least six consecutive months.
  • Neither partner has any additional STIs.  Having another STI can facilitate HIV transmission.

Risk of transmission varies with viral load, which is entirely unique to each individual. Consistent and correct condom usage is key to lowering transmission risk in mixed status couples, regardless of viral load. Condoms are highly effective in preventing the transmission of HIV, but sometimes fail. Those failures are most often due to user error. To reduce condom failure, try the following:

  • Only use water- or silicone-based lubes.
  • Never oil-based ones such as petroleum jelly, cooking oil or shortening, or hand-lotion as they weaken the latex and can cause breakage.
  • Keep condoms away from heat or direct sunlight.
  • Check the expiration date and the package. Condoms that are too old or expired, or have packaging that appears to be weathered or deflated, need to be thrown away.
  • Carefully open the condom with your fingers, trying not to tear it with your fingernails (or teeth).

HIV can complicate relationships in many ways. Not only is HIV highly stigmatized, but it can also be difficult to manage. However, under the close supervision of a good physician, you and your partner can be safely sexually active. If you need more help or want to talk about risks and options further, reach out to your primary care provider or your partners HIV specialist. If you’re a Columbia student, contact Medical Services on the Morningside campus or Student Health at the Medical Center to schedule an appointment. Information and support for Columbia students, including HIV testing and other resources, are available from the Gay Health Advocacy Project (open to all students, regardless of sexual orientation). Finally, don’t forget to check out the Columbia Morningside Safer Sex Map for free condoms and other goodies for you and your partner to enjoy.

Alice

September 26, 2013

537886
Brilliant, up to date and factual response about HIV transmission. If we had more scientific and sensible conversations around HIV, like the one posted by Alice, I am sure it would help to reduce...
Brilliant, up to date and factual response about HIV transmission. If we had more scientific and sensible conversations around HIV, like the one posted by Alice, I am sure it would help to reduce stigma and discrimination around HIV. Thank you!

December 13, 2012

520127
It could be a surprise or a shock when a person's partner is diagnosed with HIV. HIV isn't spread by hugging, kissing or sharing personal items that don't contain blood. It is also important to share...
It could be a surprise or a shock when a person's partner is diagnosed with HIV. HIV isn't spread by hugging, kissing or sharing personal items that don't contain blood. It is also important to share separate razor, toothbrushes, nail clipper or other personal items that may contain blood. HIV is spread by blood to blood test, semen or vaginal fluids. HIV can spread by oral, anal or vaginal sex. Latex is the best type of condom to use. HIV could spread if a sheep skin condom is used. Condoms greatly reduce the chance of passing HIV to a partner. A condom could break or be defective.