Recently my friends, colleagues and I have debated the idea of “magnetic” or “sero-discordant” romantic relationships, where one partner is HIV-positive and the other is HIV-negative. It seems opinions for and against can be adamant. My predecessor writing this column, Dr. Tony Zimbardi, is also a psychotherapist living with HIV, and he and I are friends and colleagues in Los Angeles. He has written about this topic before, but we disagree on this issue. He generally feels that “like should date like”, just to avoid hassle. This month, I wanted to offer an alternative view that might help others considering or maintaining a serodiscordant relationship. In a previous and in my current personal relationship, my partners have been HIV-negative, and the HIV issue has been handled relatively easily because my partners and I dealt with it head-on.
In life we date whole people, not one abstract part of them, such as their HIV antibody status. Dating someone of a different serostatus gives us the opportunity to learn and be sensitized to another’s experience, just like learning from someone of a different nationality, race, religion, cultural background, physical ability, or age, and finding what we have in common. It can also be the basis of a profound love. Those who advertise in the personal ads: “HIV Negative – UB2” are already reducing their potential relationships to an awfully simplistic level. If Romeo had only dated girls from “his side of town”, he would have missed everything that he found in Juliet!
Dating someone of different serostatus puts the emphasis on the true priorities of relationships, such as common interests, values, friendship, love, attraction, affection, and companionship. While serodiscordant relationships do require a certain amount of “safer sex accommodation”, in reality, all relationships do: there is no sexual relationship where some form of boundaries, accommodations, and constraints don’t apply, such as monogamy, choice of activities, frequency, duration, position, circumstances, etc. Most people in serodiscordant relationships wouldn’t give up the wonderful things in their partner just to be free of safer sex constraints. Some HIV-negative people don’t want to date HIV-positive people because they don’t want to deal with their own fears or bother with safer sex precautions – which is, paradoxically, more unsafe: If they have unsafe sex with a person who claims to be negative but who may be lying or just unaware of their status (as up to one third of HIV-positive Americans are), they are putting themselves at greater risk than having safer sex with someone openly positive, inadvertently “rewarding” a liar with the pleasure of unprotected sex while “punishing” an honest positive person by shunning them and promoting stigma.
Two serodiscordant people can have satisfying sex happily and safely if they take reasonable safer sex precautions. We all should already know how HIV is transmitted and the high-risk activities to avoid because of pamphlets and community education. Managing risk also involves openly discussing the amount of risk the negative partner is comfortable with and willing to take. Safer sex reduces the odds of viral transmission but doesn’t eliminate it. Similarly, driving a car involves taking some risk of injury, but if we wear a seatbelt and drive the speed limit, we reduce our risk. In safer sex, it is generally accepted that oral sex is less risky than vaginal or anal sex, but it’s not as safe as mutual masturbation, which in turn is not as safe as complete abstinence. But for most people, complete abstinence is not acceptable – just like most people would rather take the risk of driving rather than stay home.
Serodiscordant partners need to consider whether their sex fits within the parameters of safer sex education from the Centers for Disease Control and Prevention — If not, how do the partners discuss and tolerate the anxiety of “additional” risk? In the absence of hard science studying all possible sexual situations, what data, knowledge, or experience do they base their decisions on? Some serodiscordant couples become comfortable with the level of risk in their sexual repertoire because they have been doing it for a long time without seroconversion by the negative partner – is that just beating the odds, or have they developed a relatively safe set of activities? Managing risk in driving, sex, flying, or any human decision means making good educated guesses and taking reasonable precautions, and then living with some uncertainty.
Relationships take work – requiring brave discussion, give-and-take compromises, and emotional resilience. But like so many interpersonal issues, talking it out together (or with the help of an HIV-knowledgeable couples therapist) can help. If you are a negative or positive person facing the prospect of a serodiscordant relationship, don’t shy away too fast. Be brave, be cautious, be realistic, be honest, and be yourself. Don’t date an HIV status — date a person.
© Copyright 2008 – Ken Howard, LCSW, 705 Westmount Drive, #301, West Hollywood, CA 90069
For suggestions on articles, contact Ken at firstname.lastname@example.org or call 310-726-HELP(4357)