Being completely frank with people can be tough, regardless of what it is you need to discuss with them. And when the topic you need to raise is to do with your health and HIV status, it can, understandably, be particularly emotionally fraught.
“Disclosing your HIV status can be frightening and everyone’s circumstances will not be the same,” says HIV awareness activist Philip Baldwin. “Telling your partner is a decision for you and you should not feel under pressure.”
So, even though it’s World Aids Day (December 1), a day for sharing information and awareness, you do not have to talk about your personal status. Having that conversation is a “deeply personal and often nerve-wracking experience,” says Christine Schneider, clinical psychologist, psychotherapist and mental wellbeing coach at Cambridge Therapy Centre.
But if you do feel ready to talk about it with your partner, “approaching it with preparation and honesty can make the conversation more manageable,” says Schneider…
This #WorldAIDSDay, @UNAIDS is calling countries to take the RIGHTS path.
— National AIDS Trust (@NAT_AIDS_Trust) November 20, 2024
Upholding #HumanRights and including all communities living with or affected by #HIV, is essential for ending new transmissions, ensuring sustainable development and for human security. https://t.co/Z8AXKBlZwC
You don’t have to disclose your status
“In England, Wales and Scotland, if you’re having protected sex, there’s no legal obligation to disclose your HIV status,” says Chris Sheridan, lead psychotherapist at LGBTQ+ mental health app VODA. “However, you could risk prosecution for reckless transmission of HIV if you had unprotected sex, knew you had HIV and transmitted HIV to someone who didn’t know your status.”
“Ethically, being open with partners helps build trust and understanding,” they add. “If you’re on effective treatment and have an undetectable viral load (meaning you can’t pass on HIV), this significantly shapes how and when you choose to share your status.”
“Learning about HIV will empower you,” adds Baldwin. “HIV treatments suppress the virus in the body. This means that someone who is on effective treatment can’t pass it on. This is called Undetectable equals Untransmittable, or U=U. In the UK, many people living with HIV are on treatment and are virally suppressed.”
Telling a long-term partner
Before having the conversation with a long-term partner, Baldwin suggests speaking to your HIV specialist to see what they recommend, and access peer support. “Speaking to other people living with HIV who have been in a similar situation might reassure you and give you more confidence,” he says.
“Everyone’s experience of HIV is unique, but your healthcare professional or other people living with HIV will have useful advice.”
When it comes to actually broaching the subject, Sheridan says to “choose a quiet, private moment, have educational resources ready, consider involving sexual health providers and prepare information about protection options.”
They suggest starting the conversation by saying something like: “I want to share something important because I value our relationship. I’m living with HIV and managing it effectively with treatment. My viral load is undetectable, which means I can’t transmit HIV. There are also multiple ways we can protect our sexual health together. I’d like us to discuss this and explore what makes us both feel comfortable.”
“Be clear, factual, and reassuring, providing them with information about your health and how you’re managing your diagnosis,” adds Schneider. “Highlight the advancements in treatment that make HIV manageable and drastically reduce transmission risks, such as through medication and undetectable viral loads. Allow your partner time to process the information and be ready to answer questions or point them to trusted resources.”
Sheridan notes it may also be worth considering couples counselling if helpful.
Telling a casual partner
Crucially, “decide whether to share before intimacy,” says Sheridan when it comes to casual partners. Again, choose a comfortable setting and make sure to have protection methods readily available. For a conversation opener, Sheridan suggests: “I believe in being transparent about sexual health. I’m living with HIV and on effective treatment, making my viral load undetectable. This means there’s no risk of transmission. I always practice safer sex and respect my partners’ choices about protection methods. What works best for you?”
Be prepared to discuss partner protection options
“Partners have several effective prevention tools available,” says Sheridan:
PrEP (Pre-Exposure Prophylaxis) – daily medication that prevents HIV infection, available through NHS sexual health clinics. It’s over 99% effective when taken as prescribed.
PEP (Post-Exposure Prophylaxis) – emergency medication taken within 72 hours of potential exposure, available through A&E departments and sexual health clinics, most effective when started as soon as possible, not needed with partners who maintain undetectable status.
Barrier methods – condoms provide protection against HIV and other STIs, dental dams for oral sex.
Dos and don’ts
However long you’ve known your partner, Sheridan says it’s important to convey several key messages during your conversation. Firstly, “HIV is a manageable health condition – having undetectable status means untransmittable (U=U). Also, multiple effective protection options exist, regular testing benefits everyone and sexual health is a shared responsibility.”
Follow Sheridan’s quick dos and don’ts for your conversation:
Do:
Speak confidently about your health managementShare facts about modern HIV treatmentRespect their need for processing timeDiscuss broader sexual health practicesBe open about protection preferences
Don’t:
Use apologetic languageUse technical jargon unless askedFeel pressure to share more than you’re comfortable withDismiss partner concernsRush protection decisions
You may not get the response you’re hoping for
Unfortunately, no matter how you imagine the conversation going in your head, it may not go as you envisaged. “Prepare for various reactions,” says Sheridan.
“Their response reflects their understanding, not your worth. Be ready to educate about modern HIV treatment and know when to suggest professional guidance. And remember: You’re sharing information about your health management, not seeking permission or approval. Sexual health is about mutual care and respect.”
