What Is a Serodiscordant Relationship?

A Mixed-Status Relationship Where One Partner Has HIV and the Other Does Not

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A relationship is said to be serodiscordant where one partner is HIV+, and the other is not. Serodiscordant couples should not be confused with a seroconcordant relationship. In the latter, the couple share a positive HIV status.

While every relationship faces its fair share of challenges, serodiscordant couples are required to practice an extra level of care due to their respective health statuses. These couples may. otherwise be described as mixed-status, serodivergent, or discordant.

This guide will look into the potential hurdles faced by couples in this relationship type. The unique situation also calls for an examination of the risk of transmitting HIV. Lastly, the considerations for avoiding the transfer of HIV to a negative partner will be explored.

Challenges of a Serodiscordant Relationship

Relationships are built on a foundation of trust, and for serodiscordant partners, it isn't any different. When there is dishonesty in a serodiscordant relationship, however, the consequence could be continued spread of the HIV virus. For this reason, honest communication is key.

One partner may fail to share their positive status with a prospective love interest, and in other cases, they may be unaware of their disorder.

Serodiscordant couples are believed to have a major role in maintaining the HIV epidemic. In areas like sub-Saharan Africa where this virus is widespread—around 50% of HIV-positive individuals have negative partners. 

Likewise, without the appropriate measures in place, partners may live in perpetual fear of transmitting the virus to a love interest or child. In some cases, the option for safe sex may be unavailable. There is also a worrying development where HIV-negative women in developing countries find it hard to demand safer sex from their positive partners.

As another challenge, partners may feel survivor’s guilt towards their positive companion. They may feel the need to overcompensate for a positive partner’s status and can smother them with excess care.

Serodiscordant partners interested in having children may also experience difficulties. This is especially true in areas where education and systems for safe reproduction are lacking.

A potential challenge may also appear following the side effects of drug use. Antiretroviral drugs (ART) may cause bloating, weight gain, and kidney issues to name a few. These effects may affect how attractive one partner feels in the relationship.

A Positive HIV Status Is Still Stigmatized

Serodiscordant couples also have to navigate the unfavorable views about their status. Despite the leaps and bounds made in HIV management, the disease remains largely stigmatized. Couples may avoid sharing their discordance to colleagues, friends, and even family members to avoid any changes in behavior or interactions.

Risk of Transmission in Serodiscordant Couples

In mixed-status couples, there is a chance of transmitting the virus from one partner to the other. This risk is particularly high in gay male couples when compared to heterosexual counterparts. This is because the risk of transmitting the virus is increased through anal sex. 

However, by taking the right preventative steps, transmission risk may be managed in serodiscordant couples.

How to Prevent HIV Transmission in Serodiscordant Couples

Research into HIV/AIDS has offered some ease into the status of this disease. This condition is now manageable and treatable using a number of measures.

These include:

Treatment as Prevention (TasP)

Viral suppression is a reliable method to prevent the transmission of HIV. This process requires a positive person to take prescribed drugs (ARTs) to manage HIV. When taken daily and as prescribed, these drugs can help to reduce the amount of HIV in the blood (the viral load) to a low level.

By properly administering these drugs, people living with HIV can maintain an undetectable viral load. This significantly prevents the risk of transmitting the virus sexually. 

Pre-exposure Prophylaxis (PrEP)

For HIV-negative partners looking to minimize exposure to the virus, PrEP is highly recommended. This medication provides some protection to people at risk of HIV through sex or needle sharing.

When taken as prescribed, PrEP can reduce the risk of transmitting HIV through sex by around 99%.

Positive-negative couples that take their ARTs and PrEPs as prescribed are at very low risk of transmission through sex. However, for added protection and safety, serodiscordant couples may also practice safe sex using condoms

Can Heterosexual Serodiscordant Couples Have Children?

A couple having mixed HIV status does not prevent them from having children. By following the prescribed measures, discordant couples can not only prevent the transmission of HIV but even prevent its transfer to the child.

Where the man is positive in the relationship, pregnancy can be achieved through artificial insemination or through the use of sperm from a negative donor. 

This couple may also adopt sperm washing where spermatozoa are removed from seminal fluid. This is because spermatozoa are not carriers of the virus.

In cases where the woman is the positive half, transmission to her negative partner can be avoided by also adopting artificial insemination. Other options include in-vitro fertilization and intrauterine insemination. 

Where serodivergent partners prefer the traditional route for having children, safe sex will not involve condoms. Instead, couples are to ensure the strict observance of medication rules to prevent transferrence. This means being careful and consistent with ART/PrEP medications. This can ensure that viral load is kept to an undetectable level, preventing virus transmission.

Can HIV Be Passed to A Child?

A parent with a positive HIV status may not automatically transfer HIV to an unborn child. Getting an early HIV diagnosis and treatment could increase the chances of a child being born free of the virus. This is because virus-suppressing drugs may be safely administered to reduce viral load. 

HIV-infected parents could also opt for a cesarean section to prevent the transmission of the virus. This operation should be carried out before the water breaks to reduce the risk of exposure to the virus. 

Proper antenatal and post-natal care should be administered to promote the baby’s health. 

A Word From Verywell

Like all couples, serodiscordant partners can enjoy a healthy, happy partnership together. To promote the health of either partner, it’s important to take the appropriate medication and safety protocols necessary for wellness.

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