For a long time sexual relationships between people with different HIV statuses from each other were considered off-limits. Thankfully, we now have resources available to mixed-status couples to reduce the risk of HIV transmission.

Like everything else with sexual relationships, preventing HIV transmission is a team effort. It’s important for both partners in mixed-status couples to take preventive measures.

Antiretroviral therapy, pre-exposure prophylaxis (PrEP), and condoms can help both partners manage and maintain their health. Expert consultation can also help you understand your options for having children if you are a mixed-status couple.


There are a number of conspiracy theories that have done the rounds through the years about who gets infected with HIV. Initially it was known as a “gay man’s disease” with many heterosexuals feeling that they were somehow immune. It has since changed where some people believe that only certain races are affected, since HIV has proliferated through Africa, while remaining relatively controlled in western countries. Neither of these are true.

While there is a genetic component to how susceptible certain groups are to contracting the virus, there is no group of people that is even close to being invulnerable to it.

HIV can’t be transmitted from one person to another through kissing or skin-to-skin contact, such as hugging or shaking hands. Instead, the virus is transmitted through certain bodily fluids. These include breast milk, blood, semen, and vaginal and rectal excretions — but not saliva.

According to the Centers for Disease Control and Prevention (CDC) Trusted Source, having anal sex without a condom is more likely to result in a person contracting HIV than any other sexual behaviour. People are 13 times more likely to contract HIV during anal sex if they’re the “bottom partner,” or the one who’s penetrated. This applies to both men and women who are anally penetrated.

It’s also possible for people to contract HIV during vaginal sex and oral sex. Oral sex has the lowest risk, but still carries a risk.

Preventing Transmission

As a mixed-status couple you will want to be able to have sexy time with your partner. So what can be done to help you achieve this safely?

The first thing to know is that when people have high levels of HIV in their blood, it’s easier for them to transmit HIV to their sexual partners. Antiretroviral medications can be used to stop HIV from replicating, or making copies of itself, in the blood.

With these medications, HIV-positive people may be able to achieve and maintain an undetectable viral load. An undetectable viral load occurs when an HIV-positive person has so little of the virus in their blood that it can’t be detected by tests. It’s important to begin antiretroviral therapy as soon as possible after a diagnosis.

Early treatment can lower a person’s risk of transmitting HIV as well as reduce their chances of developing AIDS. People making effective use of antiretroviral medication and achieving an undetectable viral load have “effectively no risk” of transmitting HIV to their sexual partners, according to the CDC Trusted Source.

Condom usage, as well as preventive medication for the partner without HIV, can also decrease the risk of transmission. When using condoms it is important to use them as indicated on the package and to make sure that the condom has not passed its expiry date.

PrEP to Prevent HIV

If your partner is HIV-positive, you can protect yourself from contracting the virus by using medication known as pre-exposure prophylaxis (PrEP). PrEP is available in a pill form, and must be prescribed by your doctor.

PrEP is most effective when taken daily and consistently. Studies have found that daily PrEP can lower a person’s risk of contracting HIV from sex by about 99 percent. Daily PrEP reduces transmission risk by more than 74 percent for people who use injected drugs.

If PrEP isn’t taken daily and consistently, it’s much less effective.

Any person planning to have sex with an HIV-positive partner may want to consider asking a doctor about PrEP. PrEP may also benefit people who have sex without condoms and:

  • don’t know the HIV status of their partners
  • have partners with a known risk factor for HIV


Final Word

Ideally you and your partner should get tested before you have sex to know your HIV statuses. Since that isn’t always possible, make sure to always use a condom with your sexual partners.

Before having sex with someone who has a different HIV status, consider making an appointment with a healthcare provider. They can help develop a plan to prevent HIV transmission.

Many mixed-status couples have satisfying sexual relationships. They even conceive children without concern that the partner without HIV, or the children will contract the virus.