With nearly one in 20 adult South Africans now HIV positive, according to the UNAids Gap Report 2016, there’s a fair chance your partner may be one of them. When one of you is HIV positive and the other negative, you’re in what is called a ‘mixed status’ or ‘serodiscordant’ relationship. But you can still have sex safely and ensure that you have a future together if you follow these steps:
1. Know how HIV is transmitted
Understand that HIV is transmitted in blood, semen, pre-cum, vaginal and anal fluids. You can’t get it from saliva, sweat, tears or urine, so you can cuddle safely, and share the same crockery, cutlery and toilet.
2. Get your partner to take antiretrovirals (ARVs)
Help your partner get antiretroviral treatment (ART), and to keep taking ARVs exactly as prescribed. This can lower their viral load (the level of HIV in their body fluids) until it is no longer detectable, and vastly reduce their chance of infecting you. “It’s probably the single most important thing you can ask of your partner, to protect you,” says Francois Venter, executive director of the Wits Reproductive Health and HIV Institute. “If their viral load is undetectable, the chance of you getting HIV is very close to zero.”
3. Use condoms
Even then, don’t stop using condoms without discussing it with your HIV doctor or nurse. If you use them constantly and properly, male or female condoms are still the most effective way to keep HIV and other sexually transmitted infections (STIs) at bay. “Having an STI makes it easier to contract or pass on HIV,” Venter says.
4. Consider pre-exposure prophylaxis (PreP)
Ask your doctor or nurse about PrEP. This will mean you going on daily low-level ARVs (Truvada specifically) long-term, as protection against HIV infection.
The SA National Aids Council reports that clinical trials have shown PrEP lowers your risk of sexually contracting HIV by over 90%. It’s useful if you struggle to always use condoms or find yourself in high-risk situations, says Venter. “But it’s probably unnecessary if your partner is on ART and undetectable.” (Read this article for more on pre-exposure prophylaxis.)
5. Use post-exposure prophylaxis (PEP) in emergency situations
Also ask your doctor about PEP for emergency use if you’re exposed to infection, perhaps through a condom breaking. You need to start this ARV medication within three days of possible exposure, and continue for 28 days. “Again, it’s probably unnecessary if your partner is on ART and undetectable,” says Venter.
6. Be informed about your risk during sex
Know the relative risk of different sexual activities. Anal sex has the highest chance of HIV transmission, especially if you’re the receptive partner. Vaginal sex is next riskiest and more so for women. “Oral sex is very low risk, but some people still choose to use a condom or dental dam,” says Venter.
Kissing (even deep kissing) is safe so long as neither of you has mouth sores or bleeding gums. Masturbation is safe too, if you have no obvious cuts, rashes or burns on your hands or fingers that could come in contact with your HIV-positive partner’s sexual fluids. “Tiny abrasions are normal and carry no risk,’ he adds.
7. Speak about the value of a monogamous relationship
Discuss monogamy with your partner, even if you’re married, and the possible result if one of you were to have sex outside your relationship. It’s possible to get some STIs even while wearing a condom, and from oral sex.
8. Get tested
Get tested for HIV at least once a year for peace of mind that you’re still HIV negative, and so that if your status should change, you can start ARVs as soon as possible.
How Clicks Clinics can help you
Did you know Clicks offers HIV testing and counselling at their clinics? To make an appointment at a Clicks Clinic, call 0860 254 257 or book online at Clicks Clinics online.
HIV home test kits are also available for purchase in-store.
Shop for condoms on Clicks.co.za
Don't be caught unawares – rather stock up on condoms via the convenience of online shopping so that you can ensure you're practising safe sex at all times.
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