Dating Someone With HIV: Your Top Questions Answered

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Is Sex Off the Table, or Are Certain Sexual Acts a Bad Idea?

Sex is definitely not off the table if you’re dating someone who has HIV, although it’s a good idea to be cautious until you know that your partner’s treatment is effectively suppressing the virus. “We want to see their viral load persistently undetectable for six months before we say they’re not at risk for transmitting the virus,” says Michael Wohlfeiler, MD, chief medical officer of the AIDS Healthcare Foundation.

Until you know that your partner’s treatment is working as it should, you can take certain steps to ensure that you are protected, such as taking PrEP or using condoms. Additionally, different types of sex have different risks for HIV transmission. It’s important to use condoms or take PrEP if you’re having anal or vaginal intercourse, says Dr. Wohlfeiler. There is little to no risk of transmitting HIV through oral sex, including oral-anal contact, although theoretically it could be spread if semen comes in contact with an open mouth sore or bleeding gums. For this reason, Dr. Gandhi says, “use PrEP if there are any mouth sores that could increase the chance of transmissibility,” or use condoms for oral sex until you know that your partner’s treatment is working.

Once it’s confirmed that your partner’s HIV treatment has suppressed the virus to consistently undetectable levels, you don’t need to take any other precautions (such as condoms or PrEP) or avoid any sex acts to avoid getting HIV from that partner, as long as the partner continues to take their medication.

 However, if your partner stops taking their medication, their viral load may rise, which increases the risk of transmission.

Is There Any Risk From Kissing My Partner?

HIV cannot be transmitted through kissing, unless both of you have open mouth sores or bleeding gums and you’re kissing very heavily. But realistically, “kissing is perfectly safe,” says Gandhi, explaining that HIV cannot be spread through saliva.

Is It Safe to Share Food, Toilets, or Toothbrushes?

In most realistic scenarios, HIV cannot be spread by food, skin-on-skin contact, toilets, or sharing a toothbrush. There are nearly nonexistent exceptions to each of these cases, such as a theoretical risk from eating food that someone with HIV has already chewed if they have a mouth sore or skin-on-skin contact when semen is present and you have an open sore on your skin.

This minuscule risk vanishes if your partner’s treatment for HIV has suppressed the virus to undetectable levels.

What Does It Mean if My Partner’s Viral Load Is Undetectable?

An undetectable viral load means that your partner’s ART treatment is so effective at suppressing HIV that lab tests cannot detect its presence. This may also be referred to as viral suppression. Achieving this is generally the goal of HIV treatment, and it can be reached through any number of drug regimens.

If your partner stays on top of their treatment schedule and HIV in their blood remains undetectable in lab tests, they cannot transmit HIV to you or anyone else.

However, if your partner skips doses, even occasionally, their viral load could go back up, which means they could be infectious again.

 This is true even if they test as undetectable at regular appointments, says Wohlfeiler. That’s why following an HIV treatment regimen as prescribed is so important.

If someone with an undetectable viral load keeps taking their treatment as prescribed, they can expect to remain undetectable indefinitely, Wohlfeiler emphasizes.

What Role Do Condoms Play in HIV Prevention?

Condoms are very effective at preventing HIV transmission when used properly, but they generally aren’t necessary in a monogamous relationship if your partner’s HIV treatment is effective and you’ve both been screened for other STDs, such as syphilis, gonorrhea, and chlamydia.

If your relationship isn’t monogamous, “I would recommend condoms to protect your partner, especially if they don’t know you’re nonmonogamous, because of the STD risk (aside from HIV),” says Gandhi, noting that while STDs are treatable, “they can have harmful effects,” including significant discomfort. And of course, using condoms helps protect you from getting HIV from other sexual partners.

Should I Take Medication to Help Prevent HIV?

PrEP is highly effective at preventing HIV transmission. However, it isn’t necessary in a monogamous relationship if your HIV-positive partner is taking their medication as prescribed and has had an undetectable viral load for at least six months.

In rare cases, Wohlfeiler prescribes PrEP to a patient in this situation “after discussing pros and cons of the treatment and making it clear to them that from a medical perspective, they don’t really need to go on preventive therapy,” he says.

“If someone is not undetectable or for some reason can’t take their HIV medications every day, I would definitely want the negative individual to be on PrEP,” says Gandhi. “Treatment as prevention relies on people taking their medications and staying undetectable.”

Going on PrEP is also a good idea if your relationship isn’t monogamous and you’re regularly having sex with different partners, says Wohlfeiler. “If you’re going to have occasional encounters outside the relationship,” he notes, “condoms are just as effective at preventing HIV and also have the advantage of protecting you from other STDs.”

Should I Get Tested for HIV Regularly?

Yes, you should get tested for HIV regularly. The general recommendation is to get tested at least once a year if you’re dating someone who has HIV. However, your doctor may recommend more frequent testing.

Generally, Wohlfeiler recommends being tested every three to six months if you’re having sex outside your relationship or once a year if your relationship is monogamous. HIV screening involves a simple blood draw at a regularly scheduled lab or doctor’s appointment.

For someone who has an HIV-positive partner, getting tested regularly is “just good preventive healthcare,” Gandhi notes, even though your risk of getting HIV from your partner is essentially zero if their viral load remains undetectable.

What Can I Do to Support My Partner?

You can help your partner manage HIV in plenty of ways.

For starters, you can be there to just listen and offer emotional support when it’s needed. It also helps to educate yourself about HIV and steps you can both take to protect your health.

“I think the most important thing you can do to support your partner is to help them take their medications every day,” says Gandhi. “It’s really something that can be helped with partnerships.”

Wohlfeiler agrees that it’s essential to help your partner remember to take their medication consistently — for their health and for yours. “We recommend everything from reminders on their cell phone to putting it in the kitchen next to the cereal or on the night table, so they get these cues to take it,” he says. “I think the negative partner often has a fairly active role in saying, ‘Did you take your medicine?’”

The Takeaway

Learning that your partner has HIV can be overwhelming, but you can reduce your risk of getting HIV to essentially zero with effective prevention methods such as ART and PrEP. Regular HIV testing is recommended. You can also support your partner by encouraging them to stay on top of their treatment regimen and follow up regularly with their doctor to ensure their HIV levels remain undetectable.

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