Sustaining sexual safety in relationships: Hiv positive people and their sexual partners

Abstract

This paper presents findings on how sexual safety is sustained in relationships. A qualitative study was undertaken to gather data on the social relations of sexual negotiation and safety among HIV positive people and their sexual partners. HIV positive people were found to avoid close relationships because of the difficulties of sustaining safer sex with regular partners. In response, many sought HIV positive concordant partners, and unprotected sex in these relationships was considered 'acceptable'. Action that suspended protected sex helped define relationships as intimate and important. As the emotional content of relationships developed, the acceptability of risk increased. Relationship risk management in the time of AIDS is as much an effort to protect relationships as intimate, loving and secure, as it is an effort to ensure viral safety. This was particularly the case in antibody discordant relationships. Here, 'love relationships' were presented as important as life itself. It was HIV negative partners in discordant relationships who most often negotiated for unprotected sex. Gay men were better able than heterosexuals to sustain safer sex in long term, love relationships. These differences in capacity to sustain safer sex between gay and straight people and between HIV positive and negative people may reflect differences in exposure to sexual safety and relationship norms. We discuss HIV prevention initiatives in light of these findings.