When your partner is HIV positive

It is also not a good thing to think that only other HIV positive people would be interested in you. Thousands of people are in happy and safe mixed HIV status relationships.

But some people with HIV prefer to have relationships with other HIV positive people. It might seem simpler and feel more comfortable when a partner knows what it is like to have HIV. There are also no worries about infecting the other person, although there is the issue of re-infection to consider. And you might see no need to use condoms, which could be important to you.

Of course, we should never assume that a partner has HIV unless this has been shown with a test. It can be easy to assume that you both must be HIV positive but only a test will tell you for sure.

Re-infection, also called ‘superinfection’, is when you are HIV positive, have unprotected sex with another person with HIV and pick up (or pass on) a different strain of the virus. This can make you sicker faster if the new strain is more aggressive than the strain you already have. If the new strain is resistant to HIV drugs, it may also stop your drugs from working or limit the therapy you take in future.

This can make you sicker faster if the new strain is more aggressive than the strain you already have. If the new strain is resistant to HIV drugs, it may also stop your drugs from working or limit the therapy you take in future.

It is hard to say how common re-infection is, as it has not been seen in large numbers. If you have HIV you will need to find out as much as you can and make your own decision.

You are more likely to re-infect others if you have a detectable viral load, and it is more likely the higher your viral load is.

The likelihood of being re-infected by someone can be affected by:

• whether or not your viral load is undetectable
• how long you have had HIV
• whether you are taking medication.

HIV specialists and THT Direct can give advice on this.

Compared to the risk of re-infection, picking up a sexually transmitted infection from having unprotected sex is much more likely to happen. You might think that once you have HIV the worst has happened, but unprotected sex can give you infections such as herpes, syphilis, gonorrhoea and chlamydia and hepatitis C.

These STIs can interfere with your HIV treatment and make you more ill - this is called co-infection.

You and your partner should talk to each other and agree whether your relationship will be monogamous (no sex outside the relationship) or ‘open’ (sex with others allowed). There are risks in not discussing it and assuming that your partner agrees with you. Some people who think they are in a monogamous relationship find out that their partner has had sex with others.

Both monogamous and open relationships can bring benefits and challenges. For example, some couples in monogamous relationships say they enjoy feeling both physically and emotionally committed to only one person. However, they may feel frustrated if they have a higher or lower sex drive than their partner.

Some couples in open relationships say they enjoy the sense of freedom and variety it can bring, but it can also highlight any feelings of jealousy or insecurity within the relationship. Mutual trust and honest communication are vital in both monogamous and open relationships.

If you both agree to be monogamous it is important to discuss what would happen if either of you broke this agreement. If either of you feel that you must hide the fact that you’ve had sex outside the relationship, that can seriously threaten your relationship.

One advantage of monogamy is that no sexually transmitted infections (STIs) can come into your relationship.

If you have HIV, an STI can be harder to treat and, until it is treated, your HIV ‘viral load’ increases. Infections that can come into an ‘open’ relationship include syphilis, herpes, chlamydia, gonorrhoea and hepatitis C, a serious liver infection caused by a virus that some people with HIV have got from sex. There is no vaccine for hepatitis C, it can cause serious liver problems, including cancer, and treatment can be difficult and unpleasant. Re-infection with a different, more damaging strain of HIV is also possible although it is not clear how often this happens.

Using condoms with people outside your relationship will make it less likely that you’ll pick up infections (and give them to your partner) although some STIs can be passed on despite using condoms and through oral sex.