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    Sex and Intimacy With HIV

    Treatment as Prevention

    If you have HIV, one of the most important ways you can protect yourself and your partner is to stick with your antiretroviral treatment. Treatment can reduce the amount of virus in your body called the viral load, so much that it doesn't show up in tests.

    "If you have your viral load down to an undetectable level, the risk of giving HIV to someone else is quite low," says Michael Melia, MD. He's an assistant professor at Johns Hopkins University School of Medicine.

    That said, you shouldn't rely on treatment alone as protection, Melia says.

    "We always tell people to use more than one form of protection, like treatment along with a condom," says Brad Hare, MD. He's the director of the HIV/AIDS Clinic at San Francisco General Hospital. While no one form of protection is 100% effective, combining them can strengthen your defenses.

    PEP and PrEP

    In some cases, people without HIV can benefit from HIV medications.

    PEP (post-exposure prophylaxis.) This is like a "morning-after pill" for HIV. If you think you've been exposed to HIV -- maybe the condom broke -- see a doctor right away. You may be given antiretroviral drugs for 28 days. It's generally effective, but get it as soon as possible -- within 72 hours of exposure and preferably sooner.

    PrEP (pre-exposure prophylaxis) This is treatment before you might be exposed. You start taking antiretroviral drugs now to protect you from HIV if you come in contact with it.

    Who needs PrEP? An HIV-negative woman who is trying to get pregnant with an HIV-positive partner might need PrEP, says Hare. It helps protect her and the baby. If you sometimes have sex without a condom you may need to consider PrEP. Talk to your doctor.

    Other Tips for Mixed-Status Couples

    While you may focus on immediate issues as a couple -- like keeping the uninfected person safe -- you might worry about the big picture, too. What does this mean for your relationship and your future?

    Keep talking. Don't let HIV isolate you or push you apart. Communicate your worries and concerns.

    It's okay if sex seems scary right now. Focus on other ways of being intimate -- like cuddling, hugging, and casual kissing. It's important that you stay connected.

    Get help. Schedule a visit to a health care provider together to talk about HIV and prevention. Make sure you understand all the answers. Look for support groups in your area or think about couples counseling.

    Plan ahead. Don't let HIV put your life on hold. "If you or your partner have HIV, you have to plan for education, a family, a career, and retirement," Hare says, "just like everybody else."

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    Reviewed on December 12, 2013

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