There is no “right” or “wrong” time… but it's not something you should put off indefinitely.
If you’re living with HIV (human immunodeficiency virus), you are likely taking antiretroviral treatment (ART) medications. As long as you’re taking this consistently as prescribed by your doctor, the viral load of HIV in your bloodstream should generally be low. That means your risk of transmitting HIV to others is also low. You might be wondering when to tell a partner about your HIV, or if you even need to tell them at all.
There’s a public health campaign for HIV known as “U=U,” meaning “undetectable equals untransmittable.” When viral loads are low enough (thanks to ART medicines), they are undetectable on standard blood tests. When this is the case, it is very unlikely to transmit HIV to others. As a result, people with HIV can have a healthy, normal sex life, even without using condoms, as long as they are controlling their HIV with antiretrovirals.
You’re HIV Positive, Undetectable, Met Someone, and Want to Have Sex
Although the risk of transmission is minimal when your viral load is low, it’s never 0 percent. Plus, human error (such as missing doses or not taking the medicine as prescribed) can lead to a “viral blip.” This is when the viral load goes up slightly, which may increase the risk of transmission.
For these reasons, sharing your HIV status with a new partner is the ethical thing to do. This way, you and your partner can make important decisions to protect your health. (Here are more reasons why you should disclose HIV and other STIs to new partners.)
The conversation may intimidate you, but think of it this way: Open communication is an important part of physical intimacy. It’s always a good idea to be on the same page before engaging in sexual contact, including disclosing any sexually transmitted infections (like HIV).
You can talk about your HIV status like you would for other chronic illnesses. Reassure them by talking about your treatment methodology, recent doctor visits, and that your viral load is undetectable.
When to Tell a Partner About HIV
When to tell a partner about your HIV status is a personal choice and may vary, but here are some tips for choosing the right time.
- Pick a comfortable time and place to tell your partner. It’s better to have this conversation when you’re fully clothed and in a non-sexual setting, when you’re both in a good mood, and when you feel ready to take the next step in your relationship.
- Tell them before having sex for the first time. This is important so that they are able to make choices about their own sexual health. They’ll be more likely to feel betrayed or violated if you tell them after you’ve had sex.
- They may not even want to engage in penetrative sex or continue the relationship, and it’s better to know this sooner rather than later. It’s absolutely valid for them to want to take some time to educate themselves about their own protection and your condition, and they deserve that time and space.
- Consider waiting to have this conversation until after getting advice from your doctor or meeting with peer support groups to hear some tips from people who have been in your shoes (or sheets).
Being Emotionally Prepared
It’s common to feel nervous, scared, or embarrassed before telling a partner that you are HIV positive—but there is nothing to be ashamed of. You might worry that you’ll “lose” someone, or that they’ll react in a hurtful way.
While this is always a possibility to consider, you cannot control how others will behave—only how you respond to it. Give a friend, loved one, doctor, or counselor a heads up that you’ll be having this conversation so you can have a shoulder to lean on at the ready no matter what happens.
If you feel comfortable enough to be engaging with this person sexually, it is more likely than not that they will be an empathetic, concerned, and curious partner. And if they aren’t, you’re likely better off for not having gone down that road.
Stella A. Safo, MD, is an HIV primary care physician and assistant professor of Medicine at the Icahn School of Medicine at Mount Sinai Hospital.