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Mixed-HIV-Status CouplesMixed-HIV-Status Couples
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Nov 12, 2003

Hello Dr. Remien, I am hoping you may be able to point me the right direction. I have recently reunited with my ex husband who has been HIV Positive for three years, We have discussed issues openly about safe sex and have enjoyed our realtionship together so far. I do have a fear of being tested and am working on bringing myself to getting tested atleast once a year. I am wondering if there are any books that you may be able to reccomend for serodiscordant couples that may cover all the areas of being in this type of relationship...sexually, emoitionally and physically. I do not wish for this to become a part of our everyday life, but lately I have become a bit fearful of the testing results. Any suggestions would be appreciated. (we do practice safe sex with a condom, but have had a couple mishaps and I do not preform oral sex however I would like to see what other couples are doing to keep their partners safe and worry free.) Thank You for taking the time to read this.

Response from Dr. Remien

Unfortunately, I am not aware of a book of this type. It seems to me that such a book should be written because you are right - there are usually a lot of issues for such couples and they include sexual, emotional, and health issues as you have said. And many couples in this situation do find it helpful to hear from other couples in the same situation to see how they deal with some of these things. That is why I often encourage couples to explore the possibility of support groups for serodiscordant couples groups in their local area by contacting HIV-related healthcare centers and community based organizations that provide education and supportive services related to HIV.

It is also normal to feel anxious every time the HIV- partner is tested for HIV. The challenge is to not ignore HIV related issues, but also to not make them the focal point of the relationship. Life and relationships are about so much more than HIV status. From the little bit you have told me it sounds like you and your man are doing a pretty good job of this and probably have a lot of useful suggestions for others.

To offer a little specific advice about your sex behavior - keep doing what you are doing - that is, using protection for penetrative sex, while hopefully making sex fun and pleasurable. You may also want to develop a simple plan to have in place in the event of an accident (i.e, a condom breaks and ejaculation occurs). Speak with your doctor about what he/she thinks you should do when this happens. If you know that you have quick and easy access to your physician at all times, then there should be a plan to be able to reach him/her when the accident occurs. Alternatively, you should know where you could go to seek advice and possibly get medication, if advised at the time. If someone is going to pursue "post-exposure treatment" in order to prevent infection, it should be initiated within hours or a day or two after exposure - the sooner, the better. The point being you should discuss with your physician what would you do in the event of a significant exposure that would cause you to be worried and concerned.

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