HIV, Dating and Relationships

David Fawcett, Ph.D., L.C.S.W. Apr 7, 2015
  • Jason turned the corner and nearly collided with two men walking toward him on the sidewalk.  He saw that they were laughing and holding hands and immediately felt a heavy dread in his stomach. Jason flashed back six weeks earlier to the office where his suspicions had been confirmed: He tested positive for HIV. In that moment everything changed.  While he initially managed his emotions quite well, this accidental encounter with the happy couple forced him to confront his new reality: dating while positive. Jason secretly feared he would never find anyone compatible and had no idea how to even begin to think about dating and relationships.

    Like thousands of others approaching dating, Jason would be forced to maneuver the confusing swirl of stigma, medicine and, perhaps most important, core beliefs about himself. It is easy to become intimidated in an environment where online dating terms like “UB2s” and “clean” and “dirty” create the potential for self-doubt and deceit. In this context, successful dating or a committed relationship require as much internal preparation as they do social skills -- but richly rewarding experiences are out there.  One’s HIV status need not limit social connection, intimacy or personal integrity.

    An Inside Job

    A healthy relationship (or sex life, for that matter) begins with self-concept. But HIV has the unfortunate ability to bind with the self-doubt and negative beliefs we hold about ourselves. HIV-related stigma is a fact of life and it can be ugly.  No one, no matter how self-assured, wants to be rejected, yet it is a possibility. It is both hurtful and angering to experience such dismissals.  Thoughts like “I am damaged goods” or “I am unworthy” are amplified, resonating with the stigma that is already so prevalent in our communities -- creating what is one of the dangerous consequences of HIV: isolation. People wonder how they could ever meet someone who will accept them, and struggle with revealing their status to dates or sex partners. Others respond by not disclosing to partners, or avoiding getting tested altogether.

    The solution lies in finding comfort with oneself.  HIV must be incorporated into one’s self-concept, not by allowing it to become our defining characteristic, but by accepting it as a condition we live with. This process takes time and the process is lengthened not only when we witness stigma and discrimination, but when our internal whispers (or shouts) of shame introduce self-doubt. These negative core beliefs must be actively challenged and replaced, a process which may release lots of uncomfortable emotions.  This may require the assistance of a counselor, and will certainly require the gentle encouragement of supportive friends or family. Each individual follows a different path toward acceptance with no single timetable, but everyone can arrive at a place where they feel deserving of a happy and rewarding personal life.

    Once you have replaced all that negative chatter with something more affirming, it’s time to get out there.  Here are five things to keep in mind:

    • Stay resilient and authentic

      In addition to plain old common sense, emotional resilience is essential to survive the bumps and bruises of dating or forming a serious relationship. In my experience, resilient people are those who are self-aware, take calculated social risks, feel and express emotions appropriately and most importantly, who nurture and protect that essential internal flame of self-worth, no matter what.

    • Have fun

      Don’t let this virus rob you of the playful joy of human connection. HIV has the potential to convert sex and dating -- pleasurable and normal human experiences -- into frightening exercises of devastating potential rejection. It doesn’t have to be so. Staying informed with good medical information about risk behaviors (and your tolerance for them), along with some self-confidence, greatly contributes to enjoying the exhilaration of a fun date rather than suffering the rush of fear. Reclaim your joy.

    • Create a strategy

      Jumping back into dating can be overwhelming, so it is important to create a strategy that fits your desires.  Many persons living with HIV select partners on the basis of their HIV status, a practice called serosorting. Remember that one in five people who have HIV don’t know it, and plenty more are not disclosing it. For people who do not have HIV, it can make sense to assume your partner is positive and act accordingly. Many people prefer to list their status openly in online profiles, thereby eliminating cat-and-mouse questions trying to determine if a date might accept their diagnosis. Others prefer to meet potential dates through friends or coworkers. Remember, the perfect date often materializes when you least expect it. Be open to possibilities.

    • The reveal

      Because of the stigma it carries, disclosing one’s HIV status always requires conscious thought and judgment. Every time we disclose, we become deeply vulnerable and thus must always exercise care. Evaluate each person’s need to be aware of your status (and if sex is involved, they need to know, in my opinion and potentially according to the law as well).  I have had many clients who, as a way to manage their anxiety about disclosure, blurted out their status to everyone. They later regretted it.  Others withdraw, never opening themselves to that vulnerability.  A network of peers who can share their experiences and support is tremendously valuable. Choose wisely and speak your truth. You are not alone.

    • How do I keep my partner safe?

      I have found that, by far, the greatest concern of most people living with HIV is keeping their partners safe. There are many serodiscordant (one positive, one negative) relationships that are happy and healthy (including my own).  Along with keeping viral loads undetectable, PrEP (pre-exposure prophylaxis) has added a valuable layer of protection for partners. Ultimately, good communication about emotions, wants and needs (including sex) will lead to greater levels of trust and intimacy. It’s normal for most couples to sometimes need a little help. Couples counselors can, often in just a few sessions, provide tools that will improve your relationship.

      Having HIV matters, but it need not stop you from dating or having a healthy relationship. Get ready and go for it.

    David Fawcett, Ph.D., L.C.S.W., is a social worker, certified sex therapist and clinical hypnotherapist. He has worked in the areas of mental health and substance abuse for more than 25 years.