What’s known as Treatment as Prevention (TasP) is when HIV-positive individuals go onto HIV treatment to reduce the possibility of transmitting the virus onto someone else, or in other words using treatment as a way to prevent the transmission of HIV by reducing a person’s infectiousness.
A serodiscordant relationship is one in which one partner is HIV-negative and the other is HIV-positive. All couples face conflict and obstacles, but emotions can become even more complicated when you share your life with someone who has a different HIV status than you. The conflicting emotions and feelings can sometimes be overwhelming and can leave either partner in a vulnerable position.
It is important to realise that both the HIV-negative and HIV-positive partner in the relationship will each have some concerns at the beginning and throughout the relationship.
What's important to understand is that while each partner may have their own concerns, there will probably be some common themes among them. Open and honest communication is the key to being able to come to a common ground, and being able to support one another during the relationship – good times and bad.
Talking about your feelings with each other is a practical way of working through some of the complex issues that are raised in a serodiscordant relationship. Not discussing these issues can lead to risky behaviour, greater anxiety and trouble in the future of the relationship.
Here are some key points of discussion that can be considered:
Discuss your fears and explore any feelings or issues that your other partner may be experiencing of thinking about. Identify areas where you need each other's support, or perhaps the support of a professional.
Discuss each other's concerns about transmission from one partner to the other. Come together with a safe plan that includes what precautions each of you will take, what risks you are willing to take, and what activities you feel comfortable getting up to. Other elements to consider and become informed about that may reduce concerns regarding transmission include PrEP (Pre-Exposure Prophylaxis) and what it means to have an undetectable viral load. It can also help some couples to discuss an emergency plan including knowing how to access PEP (Post-Exposure Prophylaxis) should an accidental unintended exposure incident occur. It is also worth having a discussion around how both partners feel about condom use and how that factors into what risk reduction strategies you both decide to utilise.
Be open and honest about your concerns with things like treatment side effects, difficulties adhering to the daily treatment regime, and its potential impact on both your physical and mental health. For more information about treatments and the important factors relevant to HIV treatment check out www.treatHIVnow.org.au
Talk about some of the issues regarding disclosing of each others’ HIV status outside of the relationship. While not disclosing may reduce the effects of stigma and discrimination, disclosing may increase support and reduce isolation. Keep in mind that the effects of disclosure may have more of an impact on the HIV-positive partner, and as such, it is crucial that it is a joint decision and that he has a big say in how that information is divulged and to whom.
It's important to remember that just like with any other relationship, all parties need to respect each other's decisions. You may find it helpful to seek professional support for the issues that you and your partner have the most difficulty with.