The Challenges of Serodiscordant Relationships

Barriers to a Successful Serodiscordant Relationship

• Money / Employment – Money problems are common in relationships. But, the cause of the money problems in serodiscordant relationships is unique. The cost of HIV care and medications can be significant. The positive partner may be unable to work because of illness. Such situations cause significant stress, anxiety, and resentment between the two partners. And to add to the stress, the positive partner may feel guilty because he is unable to contribute to the household finances.

• To Disclose or Not to Disclose – Disclosure becomes a problem when one partner wants to disclose to more people than the other partner. In this situation, one rule that applies to every couple:
  Except in circumstances of medical emergency or necessity, when and to whom disclosure is made is the decision of the positive partner.

  If the positive partner says no to disclosure, then the negative partner must abide by his or her wishes without question.

• Sharing Medical Information – Some positive people want their partner with them at every doctor's visit. Other positive people prefer not to share medical information or discus their medical condition. Negative partners sometimes have a hard time understanding this feeling. The negative partner needs to know the positive partner is medically okay. Fear of the unknown can be powerful. Being left out of the medical aspect of their partner’s life spawns fear and doubt, two emotions that can undermine any relationship.

• Difference of Sexual Comfort and Desire – In a serodiscordant relationship, there will be differences surrounding sex. How much risk is each partner willing to take? What type of safer sex practices will be used? In what sexual activities is each partner willing to participate? A good rule of thumb is that if either partner does not want to engage in an activity or take a risk with unsafe sex, then that partner has the final say. Regardless, differences in sexual drive and risk taking can become divisive in a serodiscordant relationship.

• Fear of the Future – As is true with any chronic illness, there is some fear related to the prospect of deteriorating future health. The negative partner dwells on questions like when will the positive partner get sick; how long will he live? Fortunately, advances in HIV care has resulted in more promising futures for those infected. As life spans continue to improve, couples will become more optimistic about what their future holds.

Dealing With the Struggles – Making it Work

• Never stop talking to one another about the relationship issues you face. Share your feelings, regardless of how sensitive or painful it may be. While the pain is short term, the benefits from openly discussing issues will have lasting effects on the relationship.

• Consider seeking professional counseling whenever you feel it will be helpful. Whether it is individual counseling, couples counseling, or both, it can be beneficial to have an impartial, trained eye help you through the tough times.

• Keep issues in perspective. While your HIV status is a significant difference between the two of you, it should not define your relationship. It is only one of many characteristics that define you as a couple and as individuals.

• Take care of one another. All relationships need the partners to find ways to care for one another, treat one another with respect, and show the loving emotions that brought you together in the first place.

• Remember that you love one another. There is a reason you are together in the first place. Never be afraid to remind one another now and again. Small little reminders of the feelings you have for one another can do wonders for a stressful time in the relationship.

• Be realistic about your situation. Don’t fool yourself into thinking your difference in HIV status will not impact the relationship. There will be times that one partner or the other will feel like they can’t take the stress any longer. Don’t fake it…if you are unhappy say so.

• Stay safe, and create guidelines. Plan to discover new ways of eroticizing your lovemaking. Make it fun. Laugh more, and don't be so serious. Share fears and feelings about certain modes of sex play.

_Sources:

Kennedy, CA. "Psychological distress, drug and alcohol use as correlates of condom use in HIV-serodiscordant heterosexual couples"; Department of Preventative Medicine and Community Health; University of Medicine and Dentistry of New Jersey; 7 Nov 1993 (11) Pg 1493-1499.

Medellin, JM. "Mixed HIV Status Couples"; Body Positive Vol XVII, No. 2 1 Jul 2004.

Safadiah, M. "When Only One of You Doesn’t Test Poz", Body Positive Jan/Feb 2002.

Smith, R. "Couples" The Encyclopedia of AIDS: A Social, Political, Cultural, and Scientific Record of the HIV Epidemic. Fitzroy Dearborn Publishers 1998.

Trisdale, S. "One Positive, One Negative: Both Happy" Positive Words 2002.

• 1
• 2