Relationships and communication

A 2-step process to ensuring a healthy, happy relationship.

Navigating sex as a mixed-status couple

A mixed-status couple is when one partner is living with HIV and the other partner(s) is not living with HIV. Due to the advances in HIV medication, people living with HIV can have a healthy and empowering relationship with people who do not have HIV.

There is no risk of HIV transmission during sexual intercourse if the person living with HIV is on effective treatment, has an undetectable viral load, and monitors their viral load through regular check-ups with their HIV specialist.

1. Always have consent

It is often hard to decide when to disclose your HIV status, there are also other factors to consider. This is a matter of personal choice, you can refer to this page for helpful tips on disclosing your HIV status and dating.

⚠️ Please note that it is mandatory in Singapore to disclose your HIV status to any sexual partner(s) beforehand and obtain their full, informed consent to have sex.

This means that the other person must understand and actually appreciate the possibility of HIV transmission during sex.

This law applies even if you have an undetectable viral load. You can read more about the law and the severe penalties here.

⚠️ It is ultimately your choice in how you decide to disclose your HIV status.

For your safety and well-being, it is recommended to have proof of the other person knowing about your HIV status and consenting to having sex with you. For this purpose, having screenshots of text messages are best.

2. Communicate your boundaries

If the other person consents to being in a mixed-status relationship, it is important to respectfully communicate each other’s boundaries and discuss ways to prevent HIV transmission.
There are various methods to prevent HIV transmission, namely: condoms, PrEP, and ‘Treatment as Prevention’. You can use one or a combination of the following methods:

Condoms

It is the most affordable option in Singapore and is the only method that can prevent both HIV and other Sexually Transmitted Infections (STIs).

PrEP

It is significantly more expensive. When taken daily, PrEP is 99% in preventing HIV transmission. Using PrEP also requires HIV tests every 3 months and intermittent kidney screening.

‘Treatment as Prevention’

This refers to the use of anti-retroviral treatment to prevent HIV transmission.

When the person living with HIV is on effective anti-retroviral treatment, has and maintains an undetectable viral load, then there is no risk of HIV transmission during sex (anal, vaginal, and oral sex). This includes condomless sex and applies regardless of gender identity and sexual orientation.

Regardless of whichever method(s) you and your partner(s) use, it is recommended that the person not living with HIV takes an HIV test once a year.

Taking an HIV test does not undermine the trust between you and your partner, a HIV test is for your own sexual wellness. If you have concerns about anonymity, you can visit Action for AIDS and take an anonymous HIV test.

Found this useful? There’s more!
This is a part of our series for people older than their 50s living with HIV. In the series, we show you how to take care of your body, mind and health.

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