By: Ann K. Avery, MD, Infectious Disease Physician at MetroHealth Medical Center
At one time, condoms were the only way to protect yourself from HIV infection. Thankfully, it's 2018 now and there more ways than just condoms (which are still cool! 😎). PrEP is a once-daily medicine that can be taken to reduce your chances of getting HIV by up to 99%! Let’s dive into how PrEP can play a role in sex, love, and relationships.
Less worry and anxiety
PrEP has really changed people’s lives by creating opportunities for couples where one person is living with HIV and the other is not, to have sex without the worry. For some couples, it can eliminate or at least lessen some of that added worry and anxiety during sex. Removing anxiety during and after sex allows people to live in the moment without fear. Instead of stressing out, they can focus on what feels good.
Now we know that U=U, and that if you are getting hot and heavy with someone who has maintained an undetectable viral load you can't get HIV. However, we get that sometimes it can be nice to have direct control over your health and that PrEP can be an added peace of mind for folks who are HIV neg time.
One woman wanted to use PrEP to protect herself against exposure to HIV. She felt anxious that a condom would break during sex or that, in the heat of the moment, they would forget to use a condom. PrEP might help prevent the spread of HIV, but it’s important to remember that PrEP doesn’t protect you from other sexually transmitted infections (STIs) and it won't stop you from getting pregnant. The best way to stop the spread of STIs and getting pregnant is to use a condom.
Improve intimacy
Intimacy can also improve between couples that work together to avoid transmitting HIV, even if only one partner is living with it. This could look like one partner using PrEP while the other works hard to rock their treatment and maintain an undetectable viral load. Maintaining an undetectable viral load and taking PrEP gives both partners the added reassurance of knowing they can’t pass on or contract the virus, allowing for uninhibited intimacy.
For some couples with open relationships, PrEP can give partners a way to open up the relationship without bringing the risk of HIV from other partners into the relationship.
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Sexual pleasure
PrEP can help improve sexual pleasure in couples too. It gives gay men the option of going bareback or being the receptive partner without having the anxiety of getting HIV. It’s important to remember that PrEP doesn’t protect against STIs, though. So if you plan to have sex without a condom, think about both you and your partner getting tested and treated for STIs first.
Some challenges with PrEP and relationships
While PrEP can introduce many positive things in your life and relationships, some people also experience challenges with it, too:
- It means having to take a medication every day.
- Stigma: People who take PrEP can sometimes be labeled as someone who has a lot of hookups.
- There may still be an extremely small risk of HIV exposure (1%) even if you or your partner take PrEP.
- PrEP should be covered by your insurance, but sometimes there are deductibles. You can get assistance with this though.
- Trust is another huge aspect of taking PrEP. PrEP requires the trust that both you and your partner will follow the boundaries you’ve established for your relationship.
Here is a great resource you can check out to discover how to talk to your partner about PrEP if it’s something you’re considering. It’s a big decision for your health, your partner’s health, and your relationship. The more that you know about PrEP going into it will help ensure that you and your partner are on the same page about changing your relationship for the better!
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