A case study is presented of an HIV positive man, on anti-retroviral therapy (ART), who is married to three women and also has partners outside of the unity. The HIV status of one of the women is negative, another one is HIV positive, not on ART and the third is on ART. We touch on the optimal management of the HIV positive family members, protecting the HIV negative wife, protecting the children in case of an accident, dealing with issues like safe sex, STI screening, infertility and erectile dysfunction in this family.