What it’s like navigating HIV when you’re in a serodiscordant relationship
Serodiscordant couples 鈥� where one person is HIV positive, the other negative 鈥� are among the most literate when it comes to tackling HIV. John Voutos reports.
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Travis Atkinson, 35, and his partner have been together for almost two years. They face numerous obstacles not faced by regular couples. This is because they are in a serodiscordant or 鈥榤ixed-status鈥� relationship. 聽聽
That is, Atkinson is HIV-positive while his partner is HIV-negative.
Atkinson, a strong advocate for people living with HIV (PLHIV) in Adelaide, says he has been living with HIV for 17 years.
鈥淢y previous partner and I of 15 years were diagnosed together,鈥� he says.
鈥淚n that time, I never thought I would ever have another partner, let alone the accepting HIV-negative partner I have now.
鈥淚 approached my current partner in the beginning with a handful of health resources. He was perfectly understanding of my situation. Now, I鈥檓 in my first serodiscordant relationship.鈥�
In 2017, it was estimated that there were 27,545 people living with HIV in Australia, last month鈥檚 surveillance report by UNSW鈥檚 Kirby Institute shows.
Of these, an estimated 89 per cent had been diagnosed, 78 per cent were receiving antiretroviral therapy (ART), and 74 per cent had a suppressed viral load, exceeding the UN target of 73 per cent for the first time.
HIV cases in NSW continue to plummet to record lows, with experts attributing the rapid uptake of pre-exposure prophylaxis (PrEP) as one of the key factors. 聽
ACON鈥檚 Associate Director of Policy, Strategy, and Research, Brent Mackie, advises that serodisco couples often have open and honest discussions to make choices that feel right for both of them.
He says ACON鈥檚 workshops facilitate these discussions by demystifying 鈥渕isconceptions towards PLHIV on treatment who have an undetectable viral load (UVL)鈥� through the undetectable = untransmittable (U=U) movement.
The U=U movement promotes the proven science that shows passing on HIV to a partner is impossible with a sustained UVL through effective treatment. An undetectable viral load (UVL) means that through treatment the virus can no longer be detected in a person’s blood, and it is impossible for them to transmit HIV.
ACON partners with Positive Life NSW and the Institute of Many (TIM) with aims to 鈥渆liminate prejudice, isolation, stigma, and discrimination鈥� for PLHIV, Mackie says.
鈥淪tigma doesn鈥檛 just affect people living with HIV, it affects us all.鈥�
Along with being an 鈥渙pen book鈥�, Atkinson is a long-term member of TIM, Australia鈥檚 largest grassroots movement for PLHIV.
Nic Holas, co-founder of TIM, says their movement is helping to empower PLHIV like Atkinson to live unabashedly and resiliently.
鈥淲e have spent decades surviving HIV stigma and discrimination. We will keep doing that, but we need the rest of the world on our side,鈥� he says.
鈥淲e need governments to endorse and promote the U=U message. We need to end HIV criminalisation by improving legal protections. We need HIV-negative people to stop seeing us as 鈥榬isky鈥� and start seeing us as equals.
鈥淲e can鈥檛 keep doing all the heavy lifting.鈥�
David Crawford, 62, reflects on his own experiences as a PLHIV in past serodisco relationships.
鈥淚鈥檝e had HIV-negative partners who were accepting and made well-informed decisions about prevention and treatments,鈥� he says. 鈥淥thers respond, 鈥榖ut I鈥檓 not on PrEP鈥�.鈥�
Crawford says PrEP is overkill in the context of undetectability.
鈥淧LHIV using treatment-as-protection (TasP) use antiretrovirals in the same way that PrEP users are,鈥� he says.
鈥淭he U.S. community generally accepts serodiscordance more because there鈥檚 an awareness of the efficacy of TasP and UVL amongst negative members.鈥�
Crawford adds that HIV stigma is accepted as a norm.
鈥淓liminating stigma and discrimination isn鈥檛 just the responsibility of PLHIV, it鈥檚 everyone鈥檚 responsibility,鈥� he says.
Atkinson shares a similar sentiment, adding that there are people living with HIV who have endured years of stigma and know that it won鈥檛 vanish overnight.
鈥淢y partner and his family are very supportive and non-judgmental,鈥� he says.
鈥淭hey don鈥檛 mind my advocacy, but he鈥檚 more private around the issue鈥� he likes to keep it within the circle.
鈥淐ertain people still assume that my partner is positive by association despite being undetectable since 2007.
鈥淒ating as a PLHIV with a UVL, people on PrEP would still insist on using protection with me. So it was for my peace of mind that I advised my partner use PrEP in the early stages of our relationship, before we later discussed discontinuing it.鈥�
Atkinson adds that he and his partner undergo three to six month maintenance at the GP.
鈥淲e don鈥檛 limit certain sexual practices and he鈥檚 still negative so it鈥檚 proof that the science is working,鈥� he says.
鈥淚 lived with HIV for six years thinking it could be a potential risk for my partners despite their awareness of U=U.
鈥淢y mind wouldn鈥檛 let me agree with them. It鈥檚 for these six years that I still have to catch up.鈥�
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