As you begin to emotionally adjust to your situation, it’s important to get the facts about being with a partner who has HIV. Certain fears about having an HIV-positive partner may be outdated, but there may also be precautions you weren’t aware of that you could take to avoid HIV Here are some questions you may have if your partner has HIV, and answers from leading experts on the virus.
1. Will I inevitably get HIV if my partner has it?
No, there’s nothing inevitable about it. “We have really astounding and highly effective methods to prevent HIV in a noninfected partner,” says Monica Gandhi, MD, a professor of medicine and associate division chief of the division of HIV, infectious diseases, and global medicine at the University of California San Francisco. Methods to prevent HIV transmission when your partner has the virus include:
Antiretroviral therapy (ART)CondomsPre-exposure prophylaxis (PrEP)Postexposure prophylaxis (PEP)
ART effectively suppresses the virus in the HIV-positive partner. It involves your partner taking drugs daily. PrEP means that you, the uninfected partner, take a daily drug to protect yourself from HIV. PEP is a drug that’s used after potential HIV exposure to prevent infection, but it must be taken as soon as possible after the exposure. Each of these methods is highly effective on its own, but there may be situations where it makes sense to combine methods for even more protection or peace of mind. Until you know that your partner’s treatment is effective, it’s important to use condoms or for you to take PrEP if you’re having anal or vaginal intercourse, says Dr. Wohlfeiler. There is little to no risk of transmitting HIV through oral sex, including oral-anal contact, although theoretically it could be spread if semen comes in contact with an open mouth sore or bleeding gums. For this reason, says Dr. Gandhi, “Use PrEP if there are any mouth sores that could increase the chance of transmissibility,” or use condoms for oral sex until you know that your partner’s treatment is working. Once it’s confirmed that your partner’s HIV treatment is suppressing the virus, you don’t need to take any other precautions (such as condoms or PrEP) or avoid any sex acts to avoid getting HIV from that partner.
3. Is there any risk from kissing my partner?
HIV cannot be transmitted through kissing, unless both of you have open mouth sores or bleeding gums and you’re kissing very heavily. But realistically, “Kissing is perfectly safe,” says Gandhi, since HIV cannot be spread through saliva.
4. Is it safe to share food, toilets, or toothbrushes?
In most realistic scenarios, HIV cannot be spread by food, skin-on-skin contact, toilets, or sharing a toothbrush. There are nearly nonexistent exceptions to each of these cases, such as a theoretical risk from eating food that someone with HIV has already chewed if they have a mouth sore, or skin-on-skin contact when semen is present and you have an open sore on your skin. This minuscule risk vanishes if your partner’s treatment for HIV is effectively suppressing the virus.
5. What does it mean if my partner’s viral load is undetectable?
An undetectable viral load means that your partner’s treatment (ART) is so effective at suppressing the virus that lab tests cannot detect its presence. Achieving this is generally the goal of HIV treatment and can be reached through any number of drug regimens. “Most of the meds now are taken once a day, and we’ve got a significant number that are single-tablet regimens,” notes Wohlfeiler. If your partner is consistently taking their medication and remains undetectable in lab tests, they cannot transmit HIV to you or anyone else. This is generally true even if they forget to take their medication for a day or two very occasionally, says Wohlfeiler. But if there is “a period of a week or longer when they didn’t take their meds, they could have been infectious” for some of that time, says Wohlfeiler, even if they test as undetectable at regular appointments. That’s why following an HIV treatment regimen as prescribed is so important. If someone with an undetectable viral load keeps taking their treatment as prescribed, they can expect to remain undetectable indefinitely, Wohlfeiler emphasizes.
6. What role do condoms play in HIV prevention?
Condoms are very effective at preventing HIV transmission when used properly, but they generally aren’t necessary in a monogamous relationship if your partner’s HIV treatment is effective and you’ve both been screened for other STDs, such as syphilis, gonorrhea, and chlamydia. If your relationship isn’t monogamous, “I would recommend condoms to protect your partner, especially if they don’t know you’re nonmonogamous, because of the STD risk [aside from HIV],” says Gandhi. “Yeah, they’re treatable, but they can have harmful effects,” including significant discomfort, she notes. And, of course, using condoms helps protect you from getting HIV from other sexual partners.
7. Should I take a medicine to help prevent HIV?
PrEP is highly effective at preventing HIV transmission but isn’t necessary in a monogamous relationship if your HIV-positive partner is taking their medication as prescribed and has an undetectable viral load. In rare cases, says Wohlfeiler, he’ll prescribe PrEP in this situation “after discussing pros and cons of the treatment and making it clear to them that from a medical perspective, they don’t really need to go on preventive therapy.” “If someone is not undetectable or for some reason can’t take their HIV medications every day, I would definitely want the negative individual to be on PrEP,” says Gandhi. “Treatment as prevention relies on people taking their medications and staying undetectable.” Going on PrEP is also a good idea if your relationship isn’t monogamous and you’re regularly having sex with different partners, says Wohlfeiler. “If you’re going to have occasional encounters outside the relationship,” he notes, “condoms are just as effective at preventing HIV and also have the advantage of protecting you from other STDs.”
8. Should I get tested for HIV regularly?
Yes, you should get tested for HIV at regular intervals, according to your doctor’s recommendation. Depending on your situation, this could be as often as every 3 months or as infrequently as once a year. Generally, Wohlfeiler recommends being tested every 3 to 6 months if you’re having sex outside your relationship, or once a year if your relationship is monogamous. HIV screening involves a simple blood draw at a regularly scheduled lab or doctor’s appointment. For someone who has an HIV-positive partner, getting tested regularly is “just good preventative healthcare,” Gandhi notes, even though your risk of getting HIV from your partner is essentially zero if their viral load remains undetectable.
9. What can I do to support my partner?
In addition to offering emotional support when it’s needed, “I think the most important thing you can do to support your partner is to help them take their medications every day,” says Gandhi. “It’s really something that can be helped with partnerships. This has been confirmed in studies that look at how regularly people with HIV take their medications. Wohlfeiler agrees that it’s essential to help your partner remember to take their medication consistently — for their health and for yours. “We recommend everything from reminders on their cell phone to putting it in the kitchen next to the cereal or on the night table, so they get these cues to take it,” he says. “I think the negative partner often has a fairly active role in saying, ‘Did you take your medicine?’”
