The first day of December every year for the last three decades has been designated as World AIDS Day. Apart from raising awareness of the AIDS pandemic and mourning for those who died of the disease since 1988, World AIDS Day has also done a great deal in fundraising for research and reducing taboo in the subject of this sexually transmitted infection.
World AIDS Day is one of eight official global public health campaigns marked by the World Health Organization (WHO). Having achieved the global target of halting and reversing the spread of HIV, world leaders and scientists have pledged to “fast-track” the elimination of HIV to “End AIDS by 2030.”
As of 2013, AIDS has killed more than 36 million people worldwide. An estimated 35 million people are living with HIV, making it one of the most important global public health issues in recorded history. While the vast majority of the infected are in Sub-Sahara Africa, there is still an estimated 1.2 million individuals in United States infected with HIV.
Despite recent improvement and access to the anti-viral treatment worldwide, the AIDS epidemic estimated to claim 2 million lives each year. How do we “fast-track” the elimination of HIV by 2030? This is the subject of discussion for a reader living with an HIV positive partner.
Dear Dr. G,
I am a female reader and I know you mainly address issues related to men’s sexual health but I hope you will answer a very important problem that I am currently facing.
I am a 29 year-old professional and have been going out with my boyfriend for the last two years. We have been getting quite serious in the relationship, but he has been avoiding intimacy.
I recently asked him why and found out he is actually HIV positive and does not want to infect me.
You can imagine how devastated I was and we broke up for a while.
It has been three months and I miss him.
I thought about it and I really love him.
I understand HIV treatment is very much improved these days.
I would like to know what are my options to stay together with an HIV positive partner. I would like to know the chances of me getting infected and whether is it possible for us to have children?
One of the most important keys of eliminating HIV is the disclosure of sexual partners of the HIV status prior to sexual relationships. Although it is extremely awkward to discuss your infection status, communicating with each other about HIV and other infections is obviously the key to a healthy and loving relationship for couples. In many countries, there are even laws requiring complete disclosure of HIV status’ prior to intercourse and failure to do so may lead to incrimination.
Of course, realizing the HIV positive status of your partner can resulting in sadness and anger, but knowing the facts about HIV transmission can empower couples of the decisions for future lives together.
The HIV positive status of one of the sexual partner is also called sero-discordant or sero-divergent relationship. Although the risk of transmission of the virus is always there, such risk can be minimized. The use of condoms consistently and correctly is the most important and highly effective method of HIV prevention. Besides, choosing a less risky sexual behavior is also encouraged.
HIV is present in blood, semen, and vaginal and rectal fluid. Therefore, sexual activities that do not involve the exchange of such bodily fluid such as kissing, carry no risk of transmission. Oral sex is generally perceived to be less risky than penetrative sex, and anal sex is considered the highest risk in sexual activity for HIV transmission.
In recent advancement, the medical adherence of ART (Antiretroviral therapy) is highly effective in lowering the partner’s viral load, keeping the partner healthy and diminishing the risk of HIV transmission significantly. Obviously, accidental exposure in an intimate relationship can sometimes be unavoidable. PrEP (Pre-exposure prophylaxis) may be a way for individuals with no HIV to prevent infection by taking medication. Such measures have been demonstrated to be highly effective.
Pregnancy in a sero-divergent is also common and possible with the help of modern technology. The HIV positive men taking ART with an undetectable viral load and the partner taking PrEP can limit the risk of transmission of the virus with unprotected sexual intercourse during period of ovulation. Such practices are natural and the reduction in the number of unprotected sex lowers of risk of infection. Other more advance measures would be sperm washing, isolating the individual sperm from HIV virus in the semen. The infection-free sperm can then be used for the IVF with no risk of transmission to the next generation.Princess Diana once said: “HIV does not make people dangerous to know, so you can shake their hands and give them a hug; Heaven knows they need it.” On that note, I hope the World AIDS Day will continue to empower us with knowledge, to love and care for each other, with or without HIV.