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Your partner and you do not have the same HIV status..Sero-discordant is the term commonly used to describe a couple in which one partner is HIV positive and the other is HIV negative i.e. with the partners having different sero-statuses.. The gender orientation of the couple is not the issue in this case. Either heterosexuals or homosexual couples may be involved in a sero-discordant relationship. Sero-discordant relationships are sometimes referred to as "magnetic". This is an illusion to the phenomenon that in nature positive and negative attract. For most Sero-discordant couples, HIV/AIDS raises two paramount concerns: the risk of HIV transmission and the likelihood of illness of one or both partners. Conversely sero-concordant is the term used to describe couples in which both couples are the same HIV status either they are either HIV positive or HIV negative. Most couples are sero-concordant sero-negative meaning neither is infected with HIV. For this couple the goal is to remain HIV negative. If a couple remains sexually monogamous within the relationship there is little chance of becoming infected with HIV. If both partners who believe themselves to be in a sero-concordant-sero-negative relationship are indeed HIV-negative and remain so over time, then HIV/AIDS poses little direct risk to them. Getting tested is the only way to know your sero-status. Many people who prefer one partner may practice serial monogamy going from one steady long term relationship to another. If this sounds like you, get tested often and practice safer sex for the first 6 months of the relationship being tested twice, once at the beginning and once at the minimum 3 months later though I prefer 6 months. If the second test is negative for both partners and you are faithful you may forgo the condoms. The reward of faithfulness is the joy of “skin to skin”. Shared HIV-negative status while not the basis of a relationship has been shown to encourage couples to remain together rather than face the risk of infection from partners of unknown status. Sero-discordant couples face a number of issues not faced by sero-concordant couples, including making a decision as to what level of sexual activity is comfortable for them. While safer sex reduces the chance of transmitting the virus it does not eliminate the risk of transmission to the HIV negative partner. There is also new research that shows that the risk of transmission is greatly reduced when the positive partner is on anti-retroviral therapy and their HIV viral load is undetectable. While it is recommended that safer sex always be practiced the chance of transmitting the virus is greatly reduced. However, some people do not know their actual sero-status but simply presume themselves to be uninfected based on their personal histories or prior HIV test results. A lack of knowledge about HIV transmission and psychological denial may lead some people to underestimate their likelihood of infection. Couples in which both partners are sero-positive face a different set of concerns. Such couples occur most frequently in certain risk groups, such as gay men and injecting drug users, or in geographic regions with high HIV sero-prevalence. For these couples, transmission may seem to be a less pressing concern. However, such couples run the risk of re-infection, in which one partner infects the other with a different and potentially more virulent strain of HIV, some currently unknown cofactor that might worsen their condition, or a sexually transmitted disease. Nonetheless, couples in which both partners are HIV-positive may be tempted to ignore safer-sex practices out of a sense that such activity poses little additional risk. Indeed, shared sero-positivity may be a bonding point for some couples, although this may not be the case if one partner infected the other. Even in this age of ART sero-concordant-sero-positive couples may worry about the future and the likelihood of future illness. Today if a person is on ART and adherent to the medication regime the chances of death by AIDS is greatly reduced. Sero-discordant couples face major concerns about both transmission and care giving. Although many HIV-negative individuals might not choose to become involved with someone who is HIV-positive, the sero-prevalence rates in some communities are so high that such couplings are almost unavoidable. In other cases, partners may already be committed to one another before their sero-discordant status is discovered or discussed. Out of concern about transmission, some sero-discordant couples become overly cautious and all but cease sexual relations. Others may become fatalistic about the inevitability of transmission and take unwise risks. Even if the partners find a level of sexual interaction with which they are both comfortable, accidental slipups and condom breaks do occur. Thus, the prospect of infection is always present, causing the infected partner to worry about transmitting the virus, and the uninfected partner may experience "survivor guilt" to the point of wishing to become infected. If the sero-positive partner becomes ill, another set of issues arise around care giving. Although the basic concerns are the same for sero-discordant couples as for sero-concordant-sero-positive couples, the divide between the two sero-discordant partners can be greater, as the two do not share the same HIV status. "Survivor guilt" may become even more acute at this stage, impairing the ability of the sero-negative partner to protect him- or herself as well as the sero-positive partner. Alternatively, some sero-negative partners may decide that they are unable or unwilling to help their partner deal with severe illness and abandon the partner to care for him- or herself. Though less common today in the age of ART, the well partner may face being called upon to assist with the suicide of the sick partner. Further reading Note: Be careful with the dates of articles you read. Articles written before ART became widespread have a very different message of death and survival them messages written within the last few years Sero-discordant couples, Canadian HIV/AIDS Information Cent |
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