South Africa has the highest HIV rate in the world. Research indicates that 1 in 5 South Africans is HIV positive. That means that it is likely that you may be in a relationship with someone why is HIV positive, and will almost definitely know someone else who is. This makes it important for all of us to understand the best ways to support our partners and protect both of our health.

You don’t need to be an expert on HIV. But understanding HIV and how to prevent exposure is critical to having a safe and healthy relationship. Don’t be afraid to ask your partner questions to educate yourself on what living with HIV means to them. The more open you can be with your communication, the better.

Believe it or not, your emotional support and willingness to talk about HIV can help your HIV-positive partner manage their healthcare better. This can improve their overall health.

A healthy relationship can include:

  • helping your partner adhere to their treatment, if needed
  • talking to a doctor about medications like preexposure prophylaxis (PrEP) or postexposure prophylaxis (PEP)
  • discussing and choosing the best prevention options available for both of you in the relationship

Following each of these suggestions can decrease the chances of HIV transmission, ease fears with the help of education, and potentially improve the health of both people in the relationship.

 

Make sure your partner is managing their HIV

HIV is a chronic condition treated with antiretroviral therapy. Antiretroviral medications control the virus by lowering the amount of HIV found in the blood, which is known as the viral load. South Africa has the worlds largest antiretroviral treatment programme. This means that there is easy access to ART for all citizens.

The goal of HIV treatment is to lower the amount of HIV in the body to the point of achieving an undetectable viral load.

According to the United States Centers for Disease Control and Prevention (CDC), someone living with HIV with an undetectable viral load won’t transmit HIV to others.

A study in the Journal of Acquired Immune Deficiency Syndromes that if same-sex couples were “working together to reach a goal,” the person living with HIV was more likely to stay on track with HIV care in all aspects.

 

Medications to prevent HIV

People living without HIV may want to consider preventive HIV medications to avoid the risk of acquiring HIV. There are two strategies for preventing HIV with antiretroviral therapy. One of the medications is taken daily, as a preventive measure. The other is taken after potential exposure to HIV.

PrEP

PrEP is preventive medication for people who don’t have HIV but are at risk of acquiring it. It’s a once-daily oral medication that helps stop HIV from infecting cells in the immune system. PrEP has been approved in South Africa, and is available to people with a high risk of infection. If you have an HIV positive partner, speak with your doctor about PrEP.

PrEP will reduce the risk of contracting HIV from sex by more than 90 percent.

A PrEP regimen involves:

  • Regular medical appointments. This includes getting screened for sexually transmitted infections (STIs) and having kidney function intermittently monitored.
  • Being screened for HIV. Screening takes place before getting a prescription and every three months after.
  • Taking a pill each day.

Besides taking PrEP, also consider other options, such as using condoms. PrEP takes one to three weeks to offer protection, depending on the sexual activity. For instance, it takes longer for the medication to be effective at protecting the vagina against HIV transmission than it does the anus. Also, PrEP doesn’t protect against other STIs.

PEP

PEP is an oral medication taken after sex if there’s been a risk of exposure to HIV. This can include instances when:

  • a condom breaks
  • a condom wasn’t used
  • someone without HIV comes in contact with blood or bodily fluids from someone with HIV and a detectable viral load
  • someone without HIV comes in contact with blood or bodily fluids from someone whose HIV status is unknown to them

PEP is only effective if taken within 72 hours after exposure to HIV. It must be taken daily, or as otherwise prescribed, for 28 days.

Use protection

Using a condom during sex decreases the risk of HIV transmission. Condoms can also protect against other STIs.

Learn how to use a condom correctly to reduce the chance it breaks or malfunctions during sex. Use a condom made of durable materials such as latex. Avoid ones made from natural materials. Research shows they don’t prevent HIV transmission.

Lubricants may also lessen the risk of exposure. This is because they prevent condoms from failing. They may reduce friction and lessen the chance of microscopic tears in the anal canal or vagina.

When choosing a lubricant:

  • Opt for a lubricant that’s water- or silicone-based.
  • Avoid using oil-based lubricants with latex condoms since they degrade the latex. Oil-based lubricants include Vaseline and hand lotion.
  • Don’t use lubricants with nonoxynol-9. It can be irritating and may increase the chance of HIV transmission.

Don’t share intravenous needles

If using needles for injecting drugs, it’s crucial not to share intravenous needles or syringes with anyone. Sharing needles increases the risk of HIV.

Final word

By practicing safe sex with condoms, it’s possible to have a healthy and complete romantic relationship with someone living with HIV. Taking a preventive medication such as PrEP or PEP can reduce the chances of exposure to HIV.

If someone with HIV has an undetectable viral load, they can’t transmit HIV to others. This is another important way the partner without HIV is protected against the virus.