Serodiscordant Couples: Making It Work

Male couple smilingKeeping your needs and feelings secret can be disastrous in any relationship, but for those who find themselves in a serodiscordant relationship, it can lead to hurt feelings, misunderstandings, anxiety, and potentially risky behavior that could put both partners in serious jeopardy.

A serodiscordant relationship is one in which one partner is HIV-positive and the other is HIV-negative. Other terms that are used to describe this type of relationship include mixed status, sero-divergent, and magnetic, to share a few.

For many couples in serodiscordant relationships, the challenges they face are similar to those experienced by anyone trying to make a relationship successful, but those challenges can take on even bigger energy with the presence of a positive HIV status.

Because of the presence of HIV, many mixed-status couples face added stress and anxiety over concerns of transmission, providing care if the HIV-positive partner becomes ill, and finding support for the emotional management of the disease. Even discussions about sex, which can be challenging in any relationship, bring up deeper fears when compounded by worries about transmission of HIV.

It is important to talk about these fears and anxieties in a safe and supportive environment where both partners can be open about their feelings. Both partners developing an attitude of willingness and a deep desire to communicate, both speaking and listening, can develop this safe environment. Talking about this openly can be a risky experience, and yet it is the most powerful means to keep a relationship healthy.

Topics that might be important to discuss may include sharing about each partner’s emotional well-being, sharing information about medical issues as they arise, discussing the stress of caregiving, and the issue of disclosure—who among friends and family gets to know about the HIV-positive status.

It is also vitally important to talk about sex. It is common in serodiscordant couples for each partner to harbor fears about the transmission of HIV during sexual contact. The HIV-positive partner often carries concerns over potentially infecting his or her partner, while the HIV-negative partner worries about becoming infected. These worries can create a barrier to true intimacy and leave each partner feeling unfulfilled. This is a time when each partner must risk talking about his or her needs, what forms of sexual contact feel safest, likes and dislikes, and how the couple can find ways to keep their sex life active and intriguing.

When these deeper levels of communication are developed, both partners feel that their needs are being met and a stronger commitment to the future of the relationship is created. There are many serodiscordant relationships that are thriving thanks to an ongoing commitment to open, honest communication based on attraction, respect, honesty, and love.

© Copyright 2013 GoodTherapy.org. All rights reserved. Permission to publish granted by John Sovec, LMFT, therapist in Pasadena, California

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • simone

    simone

    May 1st, 2013 at 12:11 PM

    wow,now this would need some serious commitment and affection.to stay in a relationship where you know your partner could infect you or get ill is a big challenge and navigating this maze is not going to be easy.not at all!

  • Playnie

    Playnie

    May 2nd, 2013 at 1:03 AM

    Shew! So glad for the explanation of serodiscordant. I had no idea what that was…never even heard of it. Glad to see some light being shed on it.

  • kyleigh

    kyleigh

    May 2nd, 2013 at 1:05 AM

    would be so hard-to have your partner infected and you not be
    would always be so worried about your partner dying
    would also be worried for your own safety
    do not envy these couples at all

  • cam

    cam

    May 2nd, 2013 at 1:08 AM

    I could definitely see how people like this would need therapy i hope there is no shame for them to get it it would help them so much.
    These people really need to talk about this or it could destroy their relationship which would be even worse and add to all of the sadness and how hard this would be.
    Maybe some people would feel like the therapist is judging them but i hope that wouldn’t be the case i mean these people need someone who can put their own stuff aside and really listen and help them work through it.
    Best wishes,
    Cam

  • Christian

    Christian

    May 2nd, 2013 at 1:10 AM

    I’d have to agree…
    talking about sex is hard enough. But having to say to someone, “I don’t want to have sex with you because you might make me sick,” would be hard times 1000.

  • Jeromy

    Jeromy

    May 2nd, 2013 at 1:12 AM

    It seems to me like. If your partner were terminally ill you wouldn’t be worried. About having sex at all. You would be so stressed out about them being sick. That you wouldn’t even want to have sex. I know some people have sex. In order to relieve stress. But I have to be relaxes. And at peace. In order to have sex. And to enjoy it.

  • melinda D

    melinda D

    May 2nd, 2013 at 3:59 AM

    I would presume that there are far more homosexual couples that live with this in the US than do heterosexual couples, but regardless of that, this would have to be a very scary relationship to continue to navigate. I think that I would spend a whole lot of time worrying about being exposed to the virus. Selfish, right? Maybe it would be different if I was in love with person already before finding out, but I am not sure that I would even want to get involed with someone of they told me from the outset. That might just be the time for me to exit.

  • Tara

    Tara

    May 12th, 2013 at 3:47 PM

    Hello, my name is Tara and I am in a serodiscordant relationship, I met my husband 10 years ago in my twenties. He is HIV and HEPC positive. We live in canada and he was infected with the viruses through blood byproduct medication he took as a child to treat his hemophelia. Look up tainted blood scandal if you want to know more about that, anyways, just wanted to give you some insight on what its like to actually be in one of these relationships. In the day to day stuff, it usually doesnt come up and most of our fights are about usual marriage stuff, not taking out the trash, etc., but yes we really dont have sex that often, not bc he is unsafe, we take every precaution, its just that its terrifying to think what could go wrong if something did, go wrong. Also, HIV does not put a mentally stable person in the mood. I am not a bad person for saying that I am just trying to be honest here. The thing that keeps us going in the relationship is that we are honest about how we feel. It becomes extra difficult for us because the disease has a stigma(gasp-yes, its true) so we keep his status a secret and that makes me wonder how many of my friends would be my friends if they knew me completely and the not knowing makes me sad. I am a nursing student and I see the biases in the healthcare system as well. Also, serodiscordant couples can have the same life experiences healthy married couples do. I have two children with my husband. There is fertility treatments available that allow us to use his biological “contribution” so that there is the oppertunity to have children, without risk to mother and baby-My first child is biologically his and me and son are fine, we used a donor for my daughter (youngest) because the process(I wont lie)was stressful because the procedure is very new so there really was no garuntee that we would be ok, so the second time around we just opted for less stress and went the donor route-and let me tell ya, having experienced both a biological and donor child I can tell you that the bond a father has with a child does not come from dna. Anyways, me and my kids are healthy, we live in the suburbs, have a great life, you would never suspect a thing-So at this point you either think I am nuts or very progressive LOL. I hope this helped :) Its not all roses either, there are days when he doesnt wash the dishes, or he says something that pisses me off lol, but thats the thing that makes us normal too..what ever normal even means these days

  • Kyleh

    Kyleh

    June 2nd, 2013 at 3:13 PM

    So, my name is Kyle. I was Diagnosed in march that I was positive and my partner still negative. I was only with my partner for a few months. just still in our honeymoon phase if you will. The Initial jolt to our relationship shook us deeper then either of us had thought. We are great communicators with one another, but this has driven a hidden wedge between us. It has made other miniscule issues giant elephants. I know it cant be fixed with a wave of a wand, but the more and more I look for books and studies the less I find. We are coming to a fork in the road and I have become a little frightened. If there are any tools out there that I have not been able to find yet I would greatly appreciate the support. Thank you.

  • lala

    lala

    June 23rd, 2013 at 5:46 AM

    i am in such a relationship and it is difficult. we have been going out with my girl who is positive for 5 years but now i want to marry her but we dont know yet how we will have kidz and my parents are not interested in the relationship

  • Browneyez

    Browneyez

    August 7th, 2019 at 1:37 PM

    I too am positive and I have been in serodiscordant relationships. I’ve been positive since 2011. started taking meds maybe 2014 (I hate pills) plus I was already in the depressed stage before even finding out that amped it a little made me just say (to the back of my head you go!) but I met my first negative partner I slipped and didn’t tell due to it being way in the back of my head as though I never got the diagnosis. He took me to the Dr I told him I was positive and he accepted and loved me. We had unprotected the whole year we were together thank god he is negative. Because of him I opened up from then on it wasn’t easy at all but I took every “aaawww im sorry, oh man… really?, OH WOW! UHM, I have to go ttyl when in all reality it was their pitty. I don’t need it. ive dealt with it long enough and pittied myself. Finally I came around to meeting in person getting to know people then telling them if I felt there was some type of connection. some stayed some left. But it gave me the strength and courage I needed to not be ashamed of it. Now if I tell someone ” I have a Mcdonald smile on my face and oh uhm, I also am hiv+ how do you feel about that!?” There they are just stunned to see you smiling as you say it and their questions begin. Mind you as im dishing my positivity im ALSO throwing the fact that I am undetectable have been since treatment and there is medication negative partners can take. My current partner is negative and a hypochondriac. He felt he really liked me as much as I him and here we are 7months later all he asked is help me take care of me as well. We’ve had unprotected once and then I had him tested. This is my way of lets work together. There are undetectable clients that are and have been having unprotected sex with their partners. I would only do so if I know my partner takes their meds daily as prescribed and attends their appts to make sure they are still undetectable. IT IS POSSIBLE TO HAVE KIDS KEEP TAKING THE ART and the negative partner take PrEP.

  • Confused

    Confused

    December 14th, 2013 at 3:48 AM

    Ok so I am really confused & have no idea where to turn at the moment. I was due to get married in three months time, had the whole wedding planned, but then my man got his test results back. He is HIV positive. Thank goodness we were waiting until our wedding night to have sex. I just don’t know what to do. I have a 2yo (not his) & I’m just so scared that if I continue this relationship I will be putting her life in jepody or if she gets so attached to him as her father & then he gets really sick and dies. I know he is almost at the ‘undetectable’ stage but still. What if I get infected? How will I care for my little girl then? I just wish someone would give me the answer as to what to do :(

  • T-man

    T-man

    January 18th, 2014 at 2:02 AM

    Hi everyone!
    I am in a serodiscordant relationship and have been for the past nine years. My wife is HIV negative and I am positive. We have a 7 yrs old son turning 8 this year, we also expecting a new arrival to add into our family. I am currently on HAART which I started in 2010 when my CD4 count was below 300 (268). We openly talk about our situation but it does not really bother us. We use condoms but not quiet regularly. I must say, it always brings lot of stress after engaging in unprotected sex. The fact of the matter here is that after every engagement in unprotected sex we/ she does an HIV test which has been negative ever since. All the tests were conducted by the medical lab. The only test that we never did is the one to see whether she is immnune to HIV. The question that is forever in my mind is that, if she never got infected by the time my viral load was high, what would infect her now when my viral load is below detectable levels!!!!!!!!

  • Trying

    Trying

    October 19th, 2016 at 5:22 PM

    Hi, this is all new to me. Ive met a wonderful man and he is HIV positive but undetectable, He is everything that Ive always wanted in a man. I’m in the health care field and he is teaching me so many things that I never heard of, never knew about HIV. I am scared but I am willing to stay in this relationship because he is so honest and upfront with me. I thank God for all of these websites and blogs there is so much information and help than 30, 20 years ago.

  • RNinNOLA

    RNinNOLA

    June 13th, 2014 at 9:36 AM

    Hi! I’ve been in a serodiscordant relationship for about a month now. My partner has been at undetectable levels for the last 6 years and is probably healthier than I am!
    Our first date was amazing! He told me about his status toward the end of the night. I was caught off guard and a little surprised, but I’d already fallen for him. When he told me, he said, “I know that’s a deal breaker, but…” Then I kissed him. I wanted him to know it wasn’t a deal breaker for me.
    I’m a nurse and well informed about HIV. It’s still new and we’re still figuring it out. Even if the conversations we have are uncomfortable in the short term, they ARE necessary for a lasting relationship. Being a nurse, I know the importance of reducing stigma so the last thing I want to do is treat him like a patient, and it is hard to resist the urge to ask him things like “Did you take your meds today?” We’ve gained enough trust at this point that I don’t ask about it. I trust that he will take his meds and if anything in his blood work changes, he’ll let me know.
    Even though we practice safe sex and the risk of transmission is low since he has been undetectable for so long, I’m interested in PrEP. Does anyone have experience with this?

  • APin

    APin

    November 20th, 2014 at 5:37 PM

    I am in a new and committed serodiscordant relationship. I’m neg; he’s pos, and he was open about it very early on in dating. He is healthy, and no one would ever suspect that he is positive. I’ve found myself reading most anything I can get my hands on about risks, preventions, transmission potential, etc. etc. etc. He has helped with the education process about HIV, we’ve watched youtube videos together, we’ve gone to the doctor together. He has been undetectable for a long time, takes his meds as directed, and we communicate about our sexual expectations–what we are/aren’t comfortable with. As an added protection, I’ve been on PrEP for just about a month to further reduce the risk of transmission. It really does seem like a solid prevention, and we are both happy that I’m taking it. Do some reading on it (Truvada) if you haven’t, but it’s important to know that you have to commit to the regiment. I am experiencing some side effects, but they are mild and irregular. It’s believed that the side effects diminish after a month or so, and to me, it’s worth it.

  • Mississippi

    Mississippi

    April 27th, 2015 at 8:03 AM

    My wife and are a magnetic couple also . She is neg and I am positive . Heterosexual couple . We have been having unprotected sex for a few years and she is still negative . I take my Meds everyday on time and I am undetectable less than 3 copies .

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