Valentine’s Day, as legend has it, originated when St Valentine took it upon himself to secretly help couples tie the knot when marriage was illegal under Roman law. The Romans may have killed St Valentine when they found out, but his dedication to upholding the right to love and be loved in spite of his own personal safety is remembered and celebrated today.
HIV/AIDS is a highly stigmatized and feared disease because it strikes in many the fear of death. Modern medicine has created its own St Valentine through anti-retroviral therapy (ART) and given us all the chance to live and love safely in the face of potential death. To live: once a death sentence, HIV is now a chronic and manageable disease, where millions of people reach the same lifespan as their HIV-negative counterparts. To love: but have we really clawed back our right to romance yet?
HIV can disrupt romance in three significant ways:
- The threat of HIV in the background and a real need to check whether it’s come into the bedroom with you, can make it difficult to remember romance in the heat of the moment.
- 36 million people live with HIV worldwide, including a growing number of adolescents who were born with the virus. While ART does allow for people to live longer lives, it doesn’t make it easier to find accepting relationships or reassure potential partners.
- Given the stats, it isn’t that unlikely that your soul mate could be HIV-positive; but, it can feel difficult to provide care for your partner, protect yourself from infection, and still keep the romance.
Surrounded with HIV:
In 2015, 40% of people living with HIV were unaware of their status. The last thing you want to be worrying about when smelling the roses he bought you or holding her hand as you stroll down the beach is whether tonight’s activities are going to land you on life-long medication. Unfortunately, this is a reality for all of us and even if as an individual you consider yourself low-risk, living in an area or country with a high HIV incidence puts you at risk. Luckily, the world has evolved past preaching abstinence, and there are many options:
- Know yourself: knowing your status means you can act accordingly to protect yourself and your partner.
- Be PrEPpared: you are considered to be at high risk for HIV-infection if you are sexually active in a high HIV prevalence population (FYI an estimated 7 million people in South Africa are HIV-positive), having sex without a condom or have a partner with any HIV risk factors. If condoms are unavailable or difficult to negotiate, PrEP (a daily pill that when taken consistently will prevent you from getting HIV) and male medical circumcision (which reduces a man’s chance of contracting HIV during sex by approximately 60%) are good alternatives.
- Talk to your partner: HIV should be a normal and continuous conversation with any partner. Don’t be scared to bring it up, and if it’s your date that mentions it first, be supportive and open to the conversation.
Being safe doesn’t mean you have to stop being sexy; but just like finding a restaurant table on Valentine’s Day, it’s better to be prepared and think about these things in advance.
Living and loving with HIV:
For some, living with HIV can seem like a barrier to romance and relationships. In today’s world, that doesn’t have to be the case. Knowing your status means you can protect both your health and your loved ones. Anyone diagnosed with HIV can immediately start ART in South Africa, regardless of CD4 count. Adherence to medication and consistently checking your viral load frequently is sufficient to keep yourself well and prevent transmission of the virus to any of your partners. In fact, HIV-positive people with a suppressed viral load are unable to transmit the virus to their partners, thus giving you the freedom to live and love without fear.
According to the 2016 WHO guidelines, partner notification and testing has been shown to increase mutual support for access to prevention, treatment and care and should be strongly encouraged (WHO, 2016). This is particularly important in sero-discordant couples, where one partner is HIV-positive, and the other is HIV-negative.
Finding out that your partner, crush or soul mate has HIV can be unexpected. However, there are many ways that you can be supportive and keep the romance. Firstly, support for care and treatment is vital, which can include going along with them to the doctor or clinic, reminding them to take their medication or nursing them through side effects. Secondly, you can prioritize HIV prevention for your own protection, such as starting on PrEP or being more proactive about always using condoms.
HIV is not a death sentence for life, and it should not be a death sentence for love. This Valentine’s Day we need to take a stand for #HIVRomance.
WHO. Guidelines on HIV self-testing and partner notification: supplement to consolidated guidelines on HIV testing services. December 2016.