Table of Contents
- You Are Not the Only One(s)
- Some Language to Know
- Meeting and Dating
- Sex and Intimacy
- Having Babies
- Long-Term Connection
- Taking Care of Yourself and Embracing Your Sexuality
If you are living with HIV or AIDS and considering dating (or already in a relationship with) someone who is not living with HIV, you are most certainly not alone. People have been dating, partnering, getting married, having sex, having babies, and generally navigating relationships across HIV status throughout the HIV epidemic. Serodifferent relationship and mixed-status couple are terms often used to describe a couple or relationship in which one partner is living with HIV and the other is not.
Romantic and intimate relationships can be challenging for anyone, and differing HIV statuses may be part of that. But nowadays, we have more information and more tools than ever to help people living with and without HIV have healthy relationships and great sexual lives with one another, with infinitely less worry about HIV transmission. Science has helped improve people’s lives; HIV stigma is what often stands in the way of the full enjoyment of those lives.
There are several terms used to describe relationships across HIV status. They all have similar meanings, though some may imply different things or be rooted in stigma. For more information about language and HIV, please see our fact sheet Why Language Matters: Facing HIV Stigma in Our Own Words.
- Discordant or serodiscordant: This term is still used in many HIV clinical writings and guidelines; many others consider the term stigmatizing because the word "discord" suggests conflict, disagreement, or misalignment (the "sero" part of these terms means "blood")
- Serodifferent, serodifference: A variation on "serodiscordant" that is not based in stigma, because "difference" does not have a built-in negative association
- Mixed-status: Refers to the different HIV statuses of the relationship's members; similar to how a couple that includes people of different races is sometimes called a "mixed-race" couple
- Magnetic: Relates positive and negative HIV statuses within a couple to the "positive" and "negative" sides of a magnet, which are attracted to one another
"['Magnetic couple'] sounds sexy and fun. It conveys something exciting and joyful exchanged between people of two different statuses." – Wanona "Nunu" Thomas, The Well Project Community Advisory Board (TWP CAB) member
The process of meeting someone and dating them can be tricky regardless of HIV status. Three important points that many people living with HIV may consider are:
- Do I want to date someone who is living with HIV or someone who is not?
- When do we talk about HIV?
- Should I disclose right away, or wait until I know the person better?
If you are looking for a positive partner, consider going to places (online and in person) where you will meet other people living with HIV. These include HIV-focused support groups, conferences, or dating websites such as hivnet.com, pozmatch.com, personals.poz.com, hivpeoplemeet.com, positivesingles.com, positivesdating.com, hivpassions.com, and hivpoz.net.
If it does not matter to you whether your partner is positive or negative, you can focus more on traditional methods – Internet dating websites or their smartphone apps, like Tinder, OkCupid, Tagged, and Plenty of Fish (POF); social media sites like Facebook Dating; singles events; places of worship; personals ads; or networking through friends.
Thoughts on dating from The Well Project's community
"I wanted to date someone with parallel values to mine. I choose not to disclose unless someone is bold enough to ask because I'm very public about my status and it'll take a very strong-minded and emotional person to deal with what comes with that level of publicity centered around addressing stigma. I decided long ago that I would not limit myself to only someone who is HIV-positive, because the idea was coming from a place of fear and I didn't like that." — Masonia Traylor, TWP CAB member
"I have met people at school, at church outings, through friends and online dating. I don't know which are easier or harder. But I do like online dating because I can read the bio and learn more about the person through questions and online messaging. It is a great way to weed out the bad ones. I have met some of my very best friends through online dating. Through friends I can ask questions and hope to get good answers. Dating is a game of chance and one in which you need to know what you really want. This means knowing and loving yourself." — Marcya Gullatte, from "Love & HIV" on The Well Project's A Girl Like Me blog
"I have had lovers come back and tell me that people asked them, 'Why are you dating her? What if you get HIV? You can die.'" — PDEES, from "Queen" on The Well Project's A Girl Like Me blog
"I truthfully told him about the HIV [on POF, a dating app]. I don't know what made me do it, but I did. And that was the first time I actually talked to someone about it other than close family and friends. And it felt good because he wanted to hear about my story and learn more. … [B]eing young, I usually would have met up with that guy and did who knows what. But because of what I've been through - finding out about the HIV and stuff - I made him and myself actually have a conversation and get to know each other." — Destiny Smith, from "Testimony" on The Well Project's A Girl Like Me blog
"For me dating is like playing Russian roulette. You have to make sure you cover yourself, like having proof or some form of documentation that you had disclosed. You will encounter plenty of people wanting to date or talk to you privately but [without] all the benefits of a real relationship. Then you have those who are uneducated and ignorant to the virus but have an open mind to learn and not pass judgement. It has been a 50/50 rollercoaster for me." — Wanona "Nunu" Thomas, TWP CAB member
For many women living with HIV, the big issue is disclosure. How and when do you tell? There is no one easy or perfect way to tell someone you are living with HIV.
Often, it is not how or when you tell, but whom you tell. If a potential partner is going to find your status unacceptable, it may not matter when you tell him/her. Similarly, if a person is going to accept you and your diagnosis, timing of disclosure may not matter.
There are two main approaches to when to tell:
- Tell and Kiss: Tell before the first kiss, often before the first date.
- Plus side: Less emotional attachment before a possible rejection
- Minus side: Sharing with someone you do not know well yet that you are living with HIV – which can mean more people knowing
- Kiss and Tell: Wait until after a few dates when you feel comfortable with the person.
- Plus side: No need to disclose to every date; more privacy
- Minus side: Potential "why didn't you tell me before?" reaction
Is one of these approaches better than the other? Not really – it is a personal choice.
It is important to remember that dating is a process of finding the right person for you. Whether or not you are living with HIV, dating almost always includes some rejection, and almost everyone has some trial runs before finding that special person!
Excerpted and adapted from The Well Project's fact sheet on Dating and HIV. Visit the fact sheet for more information on this topic.
"Suggestions on how to best deal with rejection after disclosing:
- Use a self-affirmation
- Don't take it personally
- Talk to a peer
- Don't give up! This virus is not a measure of your worth. You deserve to date and enjoy doing it!" - Masonia Traylor, TWP CAB member
Disclosure and the law
Sharing your HIV status ought to be a personal choice in every case. However, many countries and most US states have laws requiring people living with HIV who know their HIV status to disclose before sex. Whether or not a partner acquires HIV, whether or not prevention methods were used, or the person living with HIV meant any harm, they may face criminal charges if a partner accuses them of not disclosing their HIV status in a sexual relationship. These laws are unfair for many reasons. But, nevertheless, they exist. For more information, please also see our fact sheet on HIV Criminalization and Women.
Excerpted and adapted from The Well Project's fact sheet on Disclosure and HIV. Visit the fact sheet for more information on this topic.
Thoughts on disclosure from The Well Project's community
"One BIG 'do' for me is making sure to have proof that I disclosed before sex was discussed. Another is to make sure to be aware of your STI [sexually transmitted infection] and HIV status as well as the other person's BEFORE SEX!" — Wanona "Nunu" Thomas, TWP CAB member
"One of the most frustrating things about disclosing status is not only HOW they will take it, but what will they DO WITH it? Are they going to be respectful of the vulnerability it takes to give away a piece of yourself, or will they … carelessly stigmatize (and bully) me for knowing my status???" — Red40something, from "Epiphany" on The Well Project's A Girl Like Me blog
"For me honesty is important; however, that does not mean someone I newly meet needs to know or 'earns the right to know' my HIV status. I am in control of who I tell and who I do not tell. I believe in taking things slow and only sharing when I am ready to do so." — Vickie Lynn, TWP CAB member
"I have stopped hiding my status. I truly believe that irrespective of anything, I need to be strong and bold enough to disclose and advocate for HIV. I strongly believe that if the person doesn't accept me the way I am, then he is not the one for me as I can't change my illness – I have to live with it the rest of my life – and so would he, and he has to know the responsibilities and care that would go the long way in supporting me." — JoDha Hukam, TWP CAB member
"The one thing that has kept me down the longest is my desire to share my life with someone else. Let's be honest, dating is hard. I was so shy as a teen that I would literally panic every time I thought about simply saying hi to any person I had a crush on.
"Growing up positive added its own layers of difficulty to the equation. … By the time I was 16 and in love with my first boyfriend, I had to find the courage to disclose my HIV status to him after we had already had sex. I was terrified. … He wrapped his arms around me and told me he loved me. At this point I was sobbing! He was upset. Not because I didn't tell him, but because he couldn't make it go away. If he would have reacted in any other way I don't believe I would have ever dated another person." — Lynnea, from "My Cup of Tea" on The Well Project's A Girl Like Me blog
Living with HIV has at times been known to take the fun and pleasure out of sex. Many women living with HIV struggle in one way or another with intimacy after being diagnosed — whether it be with stigma, body image issues, or fear of transmission.
One extremely important and exciting development in HIV science and community is that, after years of research and lots of evidence, we now know that a person living with HIV who is taking HIV drugs and has an undetectable viral load (not enough HIV in their blood for a test to measure) cannot transmit HIV to a sexual partner. This fact is often referred to using the phrase Undetectable Equals Untransmittable, or U=U. Being able to remove that fear of a partner acquiring HIV has had an overwhelmingly positive effect on the sexual confidence of many people living with HIV.
Many women find that when they feel confident being sexual, they enjoy sex more. Part of this confidence comes from not only knowing what feels good to you and your partner, but also understanding how to practice safer sex and have it feel good. There's a lot more room for pleasure when worry and fear about HIV transmission have been addressed.
Safer, smarter sex can be fun and erotic. Other than effective HIV treatment and U=U, there are also condoms and other barriers to prevent transmission of other STIs, as well as pregnancy. If you need help talking about using condoms, check out our fact sheet on Talking with Your Partner about Condoms. In addition, pre-exposure prophylaxis, or PrEP, is a daily drug a person not living with HIV can take to keep them from acquiring HIV. It is a personal choice whether or not the HIV-negative partner still wants to take PrEP if their partner who is living with HIV has an undetectable viral load.
Being sexual – with yourself or another – is a normal part of being human. Every woman, including every woman living with HIV, is a unique human being who deserves to live a full and satisfying sexual life. And always remember: Sex is good for you! Being sexually active has several health benefits. Having sex can lower your stress levels and boost your immunity. It can lower your blood pressure and improve your heart health. And it's a good form of exercise -- it burns calories.
Being sexual can increase levels of the hormone oxytocin (the "love" or "connection" hormone), which has been shown to increase feelings of trust, generosity, and intimacy. Oxytocin, in turn, boosts endorphins, the body's natural painkillers, so that pain may improve after sex. Lastly, oxytocin promotes sleep, which is a key ingredient to living a long and healthy life.
Excerpted and adapted from The Well Project's fact sheet, Getting Your Sexy On!! Visit the fact sheet for more information on this topic.
As the positive member of the couple, what is the best part about sex, especially in a serodifferent couple?
"The ability to be completely open and honest about risks, behaviors, wants, and dislikes. Having HIV has opened the door to having direct conversations about topics that might have once been uncomfortable." — Vickie Lynn, TWP CAB member
"Trust. Trust that I, despite being HIV positive, know and safeguard my partner in every way that I can, whenever we have sex without a condom. Trust that he/she will not be HIV positive as I ensure their well-being." — JoDha Hukam, TWP CAB member
"Be patient with [your partner] and don't force them to do or move faster than their own comfortability removing their old way of thinking and skeptical behaviors. Don't judge them for their ignorant thinking. Also keep reassuring them and letting them know that it is their CHOICE of what they can and cannot deal with." — Wanona "Nunu" Thomas, TWP CAB member
Are you and a partner who is not living with HIV interested in growing your family by having children? The majority of women living with HIV are of child-bearing age. It is completely possible to have children who do not have HIV, and for the partner who is not living with HIV to stay HIV-negative. Many serodifferent couples around the world have done exactly that.
Advances in HIV treatment have increased the possibility that mixed-status couples who want to have children can safely conceive their babies "the old-fashioned way" – through sex without condoms or other barriers – as we know from U=U. They have also dramatically lowered the chances that a mother will pass HIV on to her baby (known as perinatal transmission, vertical transmission, or mother-to-child transmission). The chance of a baby acquiring HIV this way can be as low as under 1%.
The different choices for getting pregnant while reducing the chances of transmitting HIV are known as "options for safer conception." Please see the "Options for Safer Conception" section of our fact sheet on getting pregnant, for information on getting pregnant that best suit your situation.
Excerpted and adapted from The Well Project's fact sheet on Getting Pregnant and HIV. Visit the fact sheet for more information on this topic.
"Even though my boyfriend, who I've been with for the last almost eight years, has been the one to really show me what love is, I spent the beginning of our relationship still needing that validation from him. Looking to him to give me my worth and feeling lucky that he wanted to be with me. Although I am more than blessed to have him, it took me a while to realize he is also blessed to have me." — Escalice, from "Best Thing to Happen to Me" on The Well Project's A Girl Like Me blog
It is difficult enough to make short-term dating work; keeping a partnership alive and healthy for a long time is one of the great joys and challenges of life. There is no longer any reason for HIV to stand in the way of living a long life with your partner.
There are many words of wisdom online and beyond directed toward people in long-term relationships – here are just a few good tips, including one from a longtime member of The Well Project's community:
- Remember that your relationship will change. And you and your partner will change, too!
- Keep the flirting alive! Make time for dates, even after you're not "dating" anymore.
- Communicate! Nobody can read your mind.
- Don't compare yourself to others. Remember that in public and on social media, people are only letting you see the best version of themselves.
- When looking for a partner, find someone who is also your friend. It's important to love each other, but it's equally important to like each other.
- "Patience, acceptance, self-forgiveness, and unconditional love, always." — Vickie Lynn, TWP CAB member, in a serodifferent relationship since 2004
First five tips adapted from "21 Bits Of Relationship Advice From People In Long-Lasting Relationships," on BuzzFeed
For many reasons, women living with HIV can feel very isolated. If they are not already in a relationship, many women decide their days of dating (and their sex lives) are over after they are diagnosed with HIV. It can be very helpful to learn that there are other women out there, living, dating, and having great sex with HIV.
You have already read some of the wisdom from our bloggers on A Girl Like Me here in this resource; you are always welcome to read more of their words. A support group may be another good place to learn how women living with HIV and other chronic illnesses are having full, satisfying lives and relationships. You can find a support group in your area by asking at your local HIV service organization; you can also find support groups by clicking "Find a Therapist," scrolling down to "Support Groups," and entering your ZIP code on Psychology Today's website (links are US only). You may also want to think about starting your own support group.
HIV stigma may threaten your self-esteem, but know this: You deserve nothing less than the utmost respect, love, and affection – in all your relationships.
"I challenge us all to live in our beauty! To accept all that is good and work on what we think is bad, for us and no one else. To look in the mirror and speak life over our being, because our words have power. I challenge us to seek ultimate healing, to go beyond our hurt, our pain, and our traumas and to simply be the truest version of our self.
"I challenge us all to DATE, be open to love, but first date yourself, love yourself, and the rest shall fall into place.
"I still believe in love after my diagnosis. I hope you do too." — Marig2016, from "Why Are You Dating If You Have HIV?" on The Well Project's A Girl Like Me blog
Very special thanks to The Well Project's Community Advisory Board members Masonia Traylor and Wanona "Nunu" Thomas, for inspiring, suggesting, and contributing to this resource; and to our other CAB members and bloggers whose words appear here, for sharing their expertise and wisdom.