Sex is perhaps the area of intimate relationships that is impacted by HIV most directly. Some couples find that they avoid topics which emphasize their differentness from one another. Talking about things like retirement, aging or even changing jobs may feel difficult for the HIV negative partner. While new medical treatments have certainly made life with HIV better, they can also cause new stresses for the couple. The regimens are complicated in themselves.
Side effects are often nasty.
Treatments affect sexual desire differently, and usually not for the better. And there is both more hope and more uncertainty about living with HIV than ever before. The uncertainty can increase stress around issues related to future life together. It is important for mixed-status couples to not let HIV become the sole guiding concern in making decisions about moving, financial planning, changing jobs or having children. It's also important to find ways to express hopes and fears with the other partner in a way that lowers barriers and builds intimacy.