Ask any Bahamian single what finding love is like in today’s dating culture, and most of them will say it’s difficult. Add an HIV positive status to the mix, and things become infinitely more challenging.
Not only does the HIV positive individual have to deal with when and how to disclose their status, they also have battle ingrained societal stigmas.
So how does the HIV positive single navigate through it all? With care, caution and transparency, says Denise Major, a sex educator and a representative of the National HIV/AIDS Programme in the Bahamas. She with Tribune Health spoke on the sidelines of a HIV testing initiative held last Friday at Royal Victoria Gardens.
“It is difficult dating for a person who doesn’t have the virus in 2019. So it is a million times harder for those who have it,” she said. “They think, ‘How do I now disclose to my potential partner that I am HIV positive? Who will want me?’ “
Having worked with the HIV/AIDS programme for some time now, Denise said has seen several HIV-discordant couples – that is where one partner is HIV positive and the other a positive – in happy, thriving relationships.
“It is not that often that we see it because of the stigma that is associated with HIV. But we do find them around, especially if one person was born with the virus. A lot of our babies who were born with the virus are now about 30 years old and have functioning relationships, and they have children. So they have found someone who was willing to have sex with them,” she said.
Conversation and education is of extreme importance for these kinds of relationships.
Ms Major explained that HIV is transmitted through blood, semen, pre-ejaculate, rectal and vaginal fluids and breast milk.
Transmission happens in several ways, including from condom-less vaginal or anal sex with someone who has HIV, from sharing needles, syringes or other injection equipment with someone who has HIV, or from mother to child during pregnancy, childbirth or breastfeeding.
HIV is not transmitted by being near an HIV positive person, eating food handled prepared or served by an HIV positive person, neither by sharing a cutlery with or drinking from glasses of a person who has HIV; nor from touching, hugging, or kissing a person with HIV.
Just like any with any relationship process, honesty and transparency should be the starting point for the HIV-positive dater, especially when it comes to disclosing one’s status. The question of when to disclose is up to the individual.
“When it is time to have sex, you have to disclose. That may take a month or three months, or when you are comfortable disclosing and how comfortable you are. But you should be responsible enough to disclose your status. And if you don’t disclose even though you are using a condom, you put the person at risk by not telling them,” said Ms Major.
“For the person born with HIV, they are on medication their entire lives. If they are taking it consistently and correctly they are probably undetectable, meaning the virus isn’t prevalent in their blood stream. So they can go ahead and have sex safely with a partner without passing the virus on, even though we recommend always using a condom.”
For those whose relationships progress to a serious commitment, it is advised that the negative partner be placed the pre-exposure prophylaxis prevention (PrEP) pill that can stop new HIV infections and is recommended for high-risk HIV negative individuals. It does nothing to treat an existing HIV infection.
Oral PrEP is an HIV prevention strategy in which a high-risk HIV negative individual takes antiretroviral medication regularly to prevent HIV infection.
“In the dating stages it is difficult, but you have to have that conversation. You have to bring your partner to get counselled so they can have the facts,” she said.
“But it always goes back to proper condom use every time. Most times the (discordant) couple only comes off condom usage when they want to conceive a child. It is highly recommended that they continue using them in combination with PrEP,” she said.
When it comes to the discordant couple conceiving, Ms Major said the HIV positive partner will be examined by a doctor to ensure the virus is undetectable in their blood.
“This means they can have sex without transmitting the virus,” she added.
“Outside of proper condom use, adhering to medication is of utmost importance.”
This is will also dictate the chance of an HIV positive person developing a functioning relationship that can bring forth children.