When Opposites Attract

Relationships come in all shapes and sizes. Almost 100,000 people live with HIV in Texas, and some are in relationships with HIV- people. There may be a big initial surprise if a romantic interest reveals a positive human immunodeficiency virus (HIV) status. For someone who is HIV-, this news can be overwhelming. If the duo continues the relationship, there may be a fear of transmitting the infection. While there is a risk, magnetic couples can have healthy sexual relationships with the proper precautions.

What is a magnetic couple?

When 2 people in a relationship have different HIV statuses, this is referred to as a magnetic couple. These couples are also called serodiscordant, serodifferent, mixed viral status, or simply mixed status. Having different HIV statuses in a relationship can create a wave of emotions for both partners. For the positive partner, there is fear of discrimination, shame, worry, and uncertainty about the relationship. The negative partner can fear infection and may even consider ending the relationship. Magnetic couples require good communication to understand the new relationship dynamics with a focus on health and wellness.

Risk of infection

The biggest question for magnetic couples is the risk of infecting the HIV- partner. There is always a risk of HIV infection in any mixed-status relationship. However, the risk is dependent on the HIV+ partner’s viral load. Someone with a higher viral load, meaning how many copies of the virus are present in the body, has a higher chance of transmission. HIV is transmitted through specific bodily fluids like blood and semen. The risk is particularly high if the couple has unprotected sex, especially anal sex. Couples who share needles for drugs or other activities are also at risk. However, if the proper medication and prevention strategies are used, the risk decreases exponentially.

Treatment as prevention

Magnetic couples can significantly reduce the risk of infection with treatment as prevention (TasP) strategies. With TasP, an HIV+ partner using the prescribed medication consistently will have an undetectable viral load, and undetectable equals untransmittable (U=U), as the saying goes. A recent study found that when gay couples had unprotected sex while viral loads were suppressed, there was no risk of HIV transmission. This approach requires several factors, including access to preventative medicine, medication adherence, and constant testing. However, research shows magnetic couples can have safe relationships with the proper treatment.

Keeping magnetic couples safe

The goal of any magnetic couple is for the positive partner to have an undetectable viral load. That means the HIV+ partner must consistently use medication to reduce the burden. However, medication importance and adherence can become the responsibility of both parties. The HIV- partner can also consider pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) to stay safe. Both are medications that can prevent HIV infection, especially in high-risk situations. The couple must also discuss safe sex practices. Remember, there are also sexually transmitted infections (STIs) to consider. This includes correct condom use, avoiding certain behaviors, and practicing proper hygiene.

Building an attractive relationship

Thousands of magnetic couples today have healthy sexual and emotional relationships. However, there is always the risk of infection, especially if the couple isn’t taking the proper precautions. However, appropriate medication use and safe sex practices can reduce infection rates significantly. Good communication can build an attractive relationship.