When HIV-negative and HIV-positive people start dating,  the fear of transmitting HIV during sex might overshadow the potential for a long-lasting relationship. Even if practicing safe sex, people may not be able to enjoy sexual activity because of fears about HIV.

While maintaining a mixed status relationship comes with immense challenges, conquering those challenges with proactive prevention methods helps to ensure that the HIV-negative partner remains negative and that the HIV- positive partner maintains good health. There are also ways to overcome this emotional discomfort. In turn, the couple can focus on establishing their connection and growing as a couple.

How HIV Transmission Occurs

HIV transmission occurs via the exchange of the following body fluids:

• blood
• semen
• pre-semen
• rectal fluid
• vaginal fluid.

The only sexual activity that involves zero exchange of body fluids is touching. 

Condoms

Condoms should be used for oral, vaginal, and anal sex.  In the case of men performing oral sex on women, dental dams should be used. Dental dams should also be used for mouth to anus contact between both men and women.

The correct procedure for putting on a condom is:

• Check the expiration date. Do not use if out of date.
• Put the condom on before making contact with the mouth, vulva or rectal area.
• To put on a condom, the penis must be erect.
• Open the condom with your hands. Do not use your teeth or a sharp object.
• Squeeze the condom tip with the fingers then place the rolled part over the head of the penis.
• Leave a small space measuring about half of inch at the end of the condom. This is where the semen will be collected.
• Hold the condom tip and unroll the rest of the condom with your other hand, rolling all the way to the pubes.
• Upon orgasming into the condom, carefully place hands around the open end of the condom near the pubic area. This prevents semen spillage during removal. Remove the penis away from the other person to avoid spillage onto him or her.  All of this should be done while still rigid. Next, move away from your partner and take off the condom.
• Only use a condom one time. 

Dental Dams

Dental dams are placed over the vulva or rectum prior to oral sex.

Use latex friendly lube or a few drops of water on the area to heighten pleasure and to secure the latex. Only use dental dams one time.

Emotional Issues

Even if all the proper precautions are taken, fear may still be wrecking havoc within the relationship.

If this is the case, it might make sense to look into taking PrEP, which is a way that people with a negative status can help prevent the chances of becoming positive. It involves taking a daily dose of a pill called Truvada. This method has been proven highly effective.

But if fear is still an issue, it may be time to talk to a professional HIV counselor or a mental health professional. It’s a good idea to do this without making accusations about HIV that will upset your partner. Fear is often based in ignorance and it is possible that there’s a lot you need to learn about HIV, facts that will put your mind at rest about new treatments and prevention measures such as the PrEP. If you began expressing unfounded fears, you may insult your partner in a way that is not only offensive, but irreparable. Know the facts.

It’s also okay to take sex slowly or only engage in certain activities. Both partners might prefer avoiding intercourse in favor of less risky sex acts. What consenting adults do in their bedroom is their own (hopefully happy!) business.

If you can’t work past these feelings, then it would be best to do the adult thing and let your HIV positive partner move on in a positive way, far from the truly negative aspects of having to deal with a fear based relationship that might take a toll on his or her happiness.

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