SEATTLE — Dr. Elyse Tung had to break the news to a patient this week that he is HIV-positive. The patient is part of a couple who visited Tung's clinic to discuss a preventive drug called Truvada that protects users from HIV. The couple have an open relationship and both scored high on an index that clinicians use to gauge risk for the virus. The man's partner started taking the drug three months ago, and had tried to convince him to begin treatment ever since.