Gay and bisexual men continue to account for the largest proportion of new HIV infections each year in the United States. While the disease is no longer the death sentence it once was, HIV remains a serious health condition, and gay men should always take steps to avoid infection. Couples HIV testing and counseling is an increasingly effective way for gay men to manage the issues surrounding HIV infection. Find out why.

HIV infections in gay men

In 2010, gay men aged 13 to 24 accounted for 72 percent of new HIV infections for all people in that age group and 30 percent of new infections among all gay and bisexual men. With such a high incidence of infection, couples may want to consider ways they can most effectively deal with the issue.

At the start of a new relationship, or at any time in an existing relationship, the possibility of HIV infection can cause pressure. For example, a monogamous couple may want to start having sex without a condom, but both partners will need to consider the risk of infection if they haven't undergone an HIV test for some time. This situation can cause an emotional challenge that couples HIV testing and counseling (CHTC) can help you cope with.

The benefits of couples HIV testing and counseling

CHTC has helped cut the incidence of new HIV infections in Africa over the last twenty years, and the approach is now increasingly popular in the United States. With CHTC, both partners receive ongoing support through all stages of HIV testing, during the receipt of test results and for any period after this where the couple may need help to adjust to their new HIV status.

Dealing with an HIV test result in isolation is often highly stressful, especially when you are in a relationship. A positive HIV result can put your relationship under pressure, as you may need to reconsider your sexual practices. The result may also bring into question your sexual history in a way that your partner struggles to cope with.

In many cases, one partner may have decided not to disclose his or her HIV status at the start of a relationship. As the partnership progresses, it can sometimes become harder to disclose the facts, until such a time when an event (such as an HIV test) forces the issue. Counseling and support during these periods can strengthen the relationship and help both partners come to terms with life-changing information.

Some gay men struggle to explain a positive HIV status to their partner or friends. Stigma within the gay community still exists, and blame, shame and guilt are common negative feelings that can make it difficult to cope with a test result. Counseling provides a supporting framework for both men to discuss how they feel and can help you deal with some of the complexity that exists when talking to your partner about your sexual history.

Adapting the approach

CHTC is particularly effective because your counseling team can adapt the approach, according to you and your partner's needs. For example, some couples choose to undergo couples counseling to get advice about how they can enjoy a meaningful sex life once they discover that one partner has HIV. Alternatively, a younger couple may need advice and guidance on HIV prevention.

You can choose the level of support and guidance you need. You may want counseling for a short period, but some couples enjoy the benefits of CHTC for many months. When you go through the process together, you're more likely to share understanding at the same pace, especially if the counselor tailors the messages and information to your needs.

Possible negative outcomes

Counseling isn't the right solution for everyone, and CHTC may yield negative outcomes. Couples counseling can sometimes highlight other challenges and problems in your relationship, and you may conclude during or after the process that you want to split up. While this may happen without counseling, CHTC can place your relationship under scrutiny that can highlight other problems.

Both partners must accept and embrace the CHTC process. Couples counseling is more complex than individual therapy because the counselor must work with two people. As such, if one partner is reluctant or disinterested in the process, conflict can follow that you may struggle to resolve. Of course, the process can also bring out information about your partner that you may not have otherwise known. As such, you need to accept that CHTC will often significantly change the way your relationship works.

Couples HIV testing and counseling can help cut HIV infection rates and help couples cope with the stress of HIV testing. Talk to a trained counselor in your area for more information and advice about how you could benefit from CHTC.