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Sex and Dating When You're HIV-Positive

I was recently invited to speak at the Women of Wisdom group in Clark County, Oregon, a support group sponsored by Quest in Portland,  an agency for women who are HIV-positive. They asked me to talk about sex and dating when you’re an HIV-positive woman.


Since I am not personally HIV-positive, I was concerned at first about my ability to speak to the topic. But the more I thought about it, the more I realized that, although some issues may be different, the most important ones are the same – safety, consent and communication.


I started our discussion by asking that we put the “Four Agreements” in place to keep us on track.


Be impeccable with your word.

Don’t take anything personally.

Don’t make assumptions.

Always do your best.


And then I reminded them of something that I feared might become an issue during our time together – the “I got HIV the good way and she got HIV the bad way” pecking order game that no one wins.


As we all know, it doesn’t matter how you got HIV. There isn’t a better HIV and a worse HIV. There’s no shame. We’re all the same. We all have a status, positive or negative, and we can’t raise ourselves up by bringing others down.


Then I dove right into the questions that the women had given to me ahead of time.


“How do I say no to sex and save face without losing respect for myself?” 


Saying no should never feel bad. In fact, it should make you feel empowered. Saying no is about you and what you want and need. We have to take care of ourselves first before we can take care of other people. If someone makes you feel unsafe or unsure or uncomfortable or anything, you have a right and a responsibility to say no and to walk away. If you get hurt or are in trouble, it makes it harder to be a good mother or friend or parent or worker or even just a human being.  “No” is your right. Exercise it. 


“How do I date without having to constantly explain myself?”


We all have baggage that we have to explain. The trick is to practice saying it and not to be attached to a certain result when it comes to how what you have to say is received. Accept that result and move on. That’s all we can do. We have to grow to understand that what the person says is about them and not about you.


It can be hard to put yourself out there to date. You might feel like no one wants to date you. And you likely worry a lot about infecting your partner.  That’s fair. But it can’t stop you from seeking the love and acceptance that you deserve and that is most certainly out there.


“How do I date without fear of infecting my partner?”


A two-year study was done with serodiscordant heterosexual and homosexual couples. The HIV positive partners who were undetectable and had condomless sex did not infect their partners. This is achieved through consistent, daily use of a person’s HIV medication. To date, not one person with an undetectable viral load has transmitted the virus.


Still, the risk of transmitting HIV if you have an undetectable viral load is not zero. Viral load spikes have been known to occur in between regular check ups, so you can never be sure if you are undetectable for certain. So if you are not partnered, you may still want to use a condom whether you are HIV-positive or negative. But if you are partnered, then that is between you and your partner. Just like anything else in life, it’s about being smart.


Your sexual partner can also consider using pre-exposure prophylaxis, known as PrEP, as a way to prevent transmission. PrEP is a once-a-day pill that, if taken daily, has up to a 99 percent efficacy rate in preventing HIV infection.


Then I turned things around and brought these questions to the group:


1. How can you surround yourself with more people who make you feel good about yourself?


2. How are you going to cut the people out of your life who tear you down instead of build you up?


3. Some people find mantras helpful, especially those in the “Fake it till you make it” vein.  Something like, “I’m happy, safe, healthy, successful and strong. I’m a good mother, partner, friend and person.” What’s your mantra going to be?


The women’s answers led to all kinds of great discussions about finding what we’re looking for when it comes to friends and partners. It was incredibly empowering and educational for me as a speaker and, from what the women shared with me, for them as participants as well.


Before we concluded for the day, we went over a few things to remember:


1. We’re always allowed to say no.


We attract what we put out. We are attracted to the people who reflect the vision of ourselves that we like see.


2. No one has to settle, HIV-positive or otherwise.


Ask yourself, would you allow this person in your life it you weren’t HIV-positive? If the answer is no, then you should walk away.


3. What is your goal?


What’s the one thing you want to do your best at this week? It’s great to set a goal every week. It doesn’t have to be huge. It’s better for it to be attainable.  Then set a goal for the month, for six months, for the year. Set them, seek them and fulfill them.


I hope that these women got as much out of our meeting as I did and that their sex and dating lives will be happy and positive ones, because your status should not dictate your safety and happiness.