Your relationship and sexuality

Hearing that you have HIV can turn your relationship into a roller-coaster ride.

If your partner doesn't have HIVrelaties
Do you feel guilty because you have HIV? Has your partner run a risk of getting HIV? Do you feel like you are on an equal basis with your partner? Are you taking extra responsibility to make sure you do not pass on HIV to your partner?

If your partner also had HIV
Is it possible that the one person got HIV from the other?

If you do not have a partner
Are you afraid that you will never find another partner now that you have HIV? Would you prefer to have a partner who has HIV or someone who does not have HIV? Or does that not make a difference to you?

Serosorting
If you prefer to choose someone who also has HIV as a partner, that is referred to as serosorting. Some people want to do that because they think it will put them on an equal basis with their partner. Plus, you do not have to worry about infecting your partner with HIV. (It is also called serosorting if someone who does not have HIV has or looks for a partner who also does not have HIV.) Many people who have a partner who also has HIV choose to have unprotected sex with that partner. Of course you can still pass on STIs (sexually transmitted infections) to each other if one or both of you also has sexual contacts with others. There is also the risk of reinfecting the other with (a different strain of) HIV, but in practice that only happens very rarely. Even if one person has an undetectable viral load and the other still has measurable virus in his or her blood, it is rare for the one to reinfect the other. Therefore, the risk of getting an STI is the most important thing to think about if you have sexual contact with someone else who has HIV.

How great is the risk that someone could get HIV from you?
Maybe you think it is very important to have extra safe sex. It is also possible that you will not have any desire to have sex for a while. After some time, many people have just as much desire to have sex as they did before they found out that they have HIV. Why should you no longer be able to have a sex life if you have HIV? If you have safe sex, the risk is small that someone would get HIV from you. If you use medicines, if your virus is being suppressed (that is to say: if you have had an undetectable viral load for at least half a year), and if you do not have any other STIs, it is nearly impossible that someone could get HIV from you. In that case, you could consider having sex without a condom with your steady partner if he or she does not have HIV. You cannot do that with casual partners, however, since you could get an STI. If you have an STI, you might be able to pass on your HIV. If you have not yet started taking HIV medications and you find it difficult to have safe sex every time, you could consider starting earlier with HIV medications.

Vaccination against hepatitis A and B
The blood tests you have in hospital will show whether or not you have had Hepatitis A and/ or B. If you are sexually active but have not had Hepatitis A or B, it is a good idea to get vaccinated against both of those forms of Hepatitis. You can get vaccinated for free at the STI clinic of the GGD (municipal health services) or through HIV nurses in Amsterdam; you can also get the vaccination for a fee from your family doctor.

STI checkup
If you run a risk of getting an STI, you are advised to get yourself checked for STIs once every six months. You can do that at any of the STI clinics of the GGD (municipal health services) and at a number of HIV treatment centres. In a number of hospitals, when you have your blood tests done, they will also check to see if you have syphilis. If your blood-test results show that your liver levels are higher than usual, that could be a sign that you have Hepatitis A, B or C. On the other hand, you could have normal liver levels but still also have Hepatitis. Your blood tests do not look for other STIs such as Chlamydia and gonorrhoea. That is why it is advisable to get tested separately for STIs. That will include not only a blood test but also a physical examination. You can find the address of the nearest STI clinic on soaaids.nl (click on ‘zoek’ and fill in: ‘polikliniek’; the information on this site is only available in Dutch).

Sexual problems
If you are having sexual problems (regardless of whether those have anything to do with your HIV), you can always discuss those with your HIV nurse. You can also have your HIV nurse or your family doctor (GP) refer you to a sexologist.

Accident? PEP!
If your (sex) partner has in fact run a real risk of becoming infected with HIV, he or she can get treated with PEP medications. Your partner has run a risk if you had unprotected sexual contact together. But if you have had an undetectable viral load for at least half a year and neither of you have any other STIs, then your partner will have run no real risk and PEP will not be advised. If your viral load is still measurable and you had unprotected sexual contact, then your partner can get treated with PEP. In that case, your partner will need to take HIV medications for a month. He or she will need to start doing that preferably within a few hours and in any case no more than 72 hours after the risky contact). That way, the virus will not have had a chance to lodge itself in your partner’s body. It is very likely that PEP can prevent your partner from becoming HIV positive. People who have been treated with PEP experienced it as being very difficult because they hardly had any time to reflect on what they should do and because HIV medications are likely to cause side effects in the first few weeks. You can get PEP at the GGD (municipal health services) and at hospitals that treat HIV. It is a good idea to call first to find out how it works in your area.

What is safe and what is not?
You can find an extensive overview of every sex technique imaginable on soaaids.nl

Questions about safe sex and STIs?
Call the Aids Soa information line: 0900-204-2040 (cost: 10 cents a minute) or send an e-mail to: infolijn@soaaids.nl (you will receive an answer within two working days).

MantotMan
On mantotman.nl (this site is only in Dutch) you can read everything about gay sex and you can get personalised advice online about healthy sex, testing, condoms, dating, party drugs, etc. Through this site you can also arrange to have a free and anonymous test for STIs (and HIV) in Amsterdam and Rotterdam.

Hepatitis C
Hepatitis C is a serious chronic liver disease that is very difficult to treat. Hepatitis C can be passed on through unsafe sexual con- tacts. Hepatitis C is not sexually transmitted through heterosexual contact and, as it looks now, also not by gay men who do not have HIV. In recent years, it is being passed on more and more often by gay men who have HIV. The treatment of Hepatitis C is heavy and very often not successful for those who receive it. If the treatment doesn’t work, you will have to hope that your liver will manage to keep going until a new treatment is discovered – whenever that might be.

Contact

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020 6 160 160

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For questions about living with HIV. Available monday, tuesday and thursday from 2 PM till 10 PM

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