Dr. Remien,

I never thought I would find myself in a serodiscordant relationship. However, I met someone, and from the beginning knew he was poz. We started off by forming a really solid friendship, and from that a relationship grew. From the beginning he "doomed" the relationship by setting up blocks that he didn't want to be hurt and didn't want to hurt me...meaning, infect me. He was infected by a partner of 10 years who was having relations on the side. For a while, things were GREAT between us, and lately he has withdrawn while keeping daily contact. I am also very knowledgeable about HIV as I work in the field for a non-profit. I am one of the first people in his life who has taken an active role in his well-being. He swore off relationships after his status, but then met me. He recently said he was just thinking about what it would be like to be together in 15 years, and then broke down regarding his mortality. However, for the moment, after nine years of HIV he is still very healthy. I don't know if I push dialogue with him, or if I sit patiently hoping he will come around. I don't know what it's like to face the things he's facing, but I wish I could really be there for him.

Thanks in advance.

It is very difficult to know, from your description, how much of the difficulties you are having is about HIV and how much is unrelated to HIV. You are describing someone who seems to put up walls when someone gets very close to him. If he has been aware of his HIV status and in good health for nine years, I suspect it may have more to do with his fear of intimacy than specific worries about HIV. And it is likely that it is some of both. While HIV is a significant issue in mixed status relationships, it is generally not the root of all difficulties in couple intimacy.

In general, I think it is important for people in relationships to push for honesty and intimacy, while respecting each others' need for privacy and differences in preferences in the "pacing" of things. It's true, you can't fully know what it is like to be in his shoes, nor can he fully know what it is like for you. That is why dialogue is so important. And it sounds to me like you are "there for him," but that he is turning you away.

If you continue to experience significant road blocks when trying to be close, you may want to speak to a counselor to try to sort things out for yourself and figure out how to proceed. Couples counseling can also be useful, if both of you are motivated.

Take care of yourself and continue to seek the satisfaction and intimacy that you deserve in a relationship.