Preventing HIV in modern relationships

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OPINION

By Ruth Oyella

There have been reports about the increasing cases of new HIV infections amongst couples, and this discussion needs to be digested to support the government’s goal of ending HIV/AIDS by 2030.

HIV remains one of the most persistent Public Health challenges today, despite progress that has been made globally; the virus continues to spread amongst couples in ways that could be prevented.

Intimacy in relationships, ironically, can become the very space where HIV transmission thrives. To reduce HIV spread amongst couples, we must confront the causes head-on, understand what data reveals and embrace prevention strategies that empower couples to protect themselves.

That brings us to absorbing the driving factors of HIV transmission among couples;

Unawareness of HIV status, where many couples do not test regularly, leaving one partner unaware of their status until symptoms appear.

Inconsistent condom use because of trust in intimacy, which makes some couples abandon condoms without assurance of one partner’s HIV status.

Gender dynamics and power imbalance, one of the least acknowledged but most critical drivers of HIV transmission among couples, is gender inequality in sexual decision-making. In many communities, cultural norms still position men as the dominant partners who control when, how and with whom sex happens, while women are often expected to remain passive. This imbalance has direct consequences for HIV risks.

Untreated HIV due to stigma; without antiviral therapy (ART), viral loads remain high, making transmission more likely.

According to data, the numbers are sobering but also hopeful;

Globally, intimate partner transmission remains a major driver of new infections, especially in regions like Sub-Saharan Africa.

In accordance with the Uganda Population-based HIV Impact Assessment (UPHIA) survey, young women bear a disproportionate burden of new infections (four out of five adolescent girls) linked to ignorance, early marriage (over 30% married<18), and sexual violence. In my opinion, this study is linked to gender dynamics and inequality in our societies.

The CDC, HIV Public Health Partners report that condom use remains one of the most effective tools, reducing risk by up to 99% when taken consistently.

Pre-exposure prophylaxis (PrEP), a daily pill for HIV negative partners, can reduce risk by up to 99% when taken consistently.

HIV/AIDS data hub for the Asia Pacific highlights that couple-based interventions like testing together, counselling and joint prevention drastically improve outcomes.

These findings underscore a simple truth: HIV transmission among couples is not inevitable. It is preventable with the right tools and commitment.

To stop HIV in its tracks, couples must embrace a multi-layered prevention strategy;

Regular HIV testing should be normalised within relationships. Knowing your status is the first step towards prevention.

For HIV positive partners, starting and adhering to ARVs is critical. When viral load is undetectable, HIV becomes untransmittable, a powerful message that should be widely spread.

Condoms remain a frontline defence; couples should see them not as a barrier to intimacy but as a tool of love and protection.

Consideration of PrEP in Sero-discordant relationships (Where one partner is HIV positive and another is negative) offers protection and peace of mind.

Challenging stigma and gender inequality by empowering women to negotiate safe sex is essential towards healthy relationships.

Reducing HIV transmission among couples is not just a medical challenge but also a social one. We must normalise HIV conversations in relationships, expand access to ARVs and PrEP and dismantle the stigma that keeps couples from protecting themselves. Governments, NGOs and communities must invest in couple-centred interventions, making prevention a shared responsibility.

The writer is a communication Trainee in the Public Relations Unit of Ministry of Health.