Is reinfection a risk if two HIV positive people are undetectable?
What are the risk involved in two HIV+ people in a couple who are both on medications and are undetectable to re infect each other during sex without a condom?
One partner (myself) has been living with HIV for a decade while my partner has been living with it less than 6 months.
I read re infection tends to be more common within the first few years of infection.
So what does the science say about two undetectable people having condomless sex?
Thanks for your question.
The two main risks from not using a condom are pregnancy and other STIs.
If these are not a concern for you, then there is no risk. This is mainly because having an undetectable viral load on treatment makes you so dramatically less infectious that HIV transmission becomes zero risk.
Even if reinfection occurred, due to viral rebound, this would only be important if one of you had drug resistance. Because your viral loads are both undetectable, neither of you have resistance to your current meds.
So long as you continue to take meds carefully and not miss doses, there is no reason that you will develop resistance in the future either.
Although it can seem strange if you are used to using condoms, many people in your situation find that not having to always use condoms can have a positive impact on their quality of life.
Please see the reports from 2017 saying that U=U (Undetectable = Untransmittable). This shows that HIV cannot be transmitted even if you don’t use condoms.
This Q&A was updated in July 2019 to an answer posted in September 2014.