Question
If I have unprotected sex with other HIV positive people will I get resistance?
15 January 2017. Related: All topics, HIV reinfection (superinfection), HIV transmission, Resistance.
Hi,
I’m a HIV positive gay male aged 27, infected and diagnosed three years ago. I am currently healthy with a CD4 count of 560 and a viral load of 35,000 and not yet on any medication.
I’ve been scared to sleep with other positive men through fear of catching treatment resistant strains or worse. I am a passive partner and I’m afraid my question does relate to unprotected sex. I am aware of the risks associated therein, afterall it got me in this situation!
I would like to know if I were to sleep with a HIV positive guy, is it better for me if he is on meds and undetectable or would that put me more at risk of developing resistance?
Now I can ‘sero-sort’ I’d like to know what’s likely to be the safest way to prevent my situation getting any worse, be it developing drug resistance, superinfection or other hard to treat infections?
I am also immunised against hepatitis B. Am I truly safe against this if I were to unknowingly come into contact with it?
Many thanks
Answer
Thank you for your question.
Having an undetectable viral load on treatment will be better both for you and your partner.
This is because the meds also stop HIV from being transmitted. Even if your partner has drug resistance, and undetectable viral load means HIV won’t be transmitted.
Even though your CD4 count is still strong above 500, treatment guidelines still recommend treatment (ART) for your own health too.
This article explains why U=U (undetectable viral load = untransmittable HIV).
https://i-base.info/htb/32308
The HBV vaccine is also very effective. Your doctor will check you have a good immune response after your vaccination. This protectional usually lasts for at least five years but your doctor can also check this in can you need a booster in the future.
For any further information or if you need any support then please do not hesitate to contact us on the treatment information helpline (Mon-Wed 12-4pm)
The information in this answer was updated in January 2017 from a post in May 2010. Please see: Question 9 at this link for more information.
I’m starting arv’s dis month and my partner is hiv- and we planning to have a baby, would I concieve and is my baby going to be healthy?
Hi Bonolo,
If you are in a monogamous relationship and have been having unprotected sex in the past there is unlikely to be any new risk to doing this. There is still the possibility of other STIs and pregnancy. See this link for more information about unprotected sex when you’re both positive.
We just found out that my boyfriend and I are both HIV positive. Can we still have unprotected sex? Our CD4 count is above 500.
Thank you for all your advises on having sex with an hiv infected person on treatment as some people are afraid to let their partners know that they are on treatment and still continue having unprotected sex. This was a question i had for a long time,
Cheers Silwane
Hi Mary,
I’m sorry to hear about you and your partner’s diagnoses. If you have been having unprotected sex before you started treatment it is likely that any reinfection which might happen will have already happened. Continuing to have unprotected sex is therefore unlikely to be of added risk- except for pregnancy and other sexually transmitted infections.
If you and your partner have the same virus then you will have the same resistance (or no resistance) to medication. This means that having unprotected sex is unlikely to affect your treatment. One caution is that in the future, if you develop resistance, you could pass this to your partner. But so long as treatment is going well and your viral load is undetectable this should be fine. Please follow this link for more information about reinfection.
My partner and I have been tested positive for HIV. I am worried that I’m the only one being treated and we are still having unprotected sex. Will this cause my body to become resistant to my meds? Is it possible that this could hurt me with my treatments?
No one can tell your what your individual risk would be. The risk will be lower compared to if your partner was not on treatment. These studies were with heterosexual vaginal sex. The risk for anal sex is also likely to be reduced, but it is not reduced to zero.
One aspect of these studies that is most useful is that it can remove any residual worry you might have about a condom breaking. So the safest advice is to still use a condom, but if it breaks, the risk becomes low enough probably not to need PEP.
I was wondering. What if I am hiv- negative and my partner is HIV+ but on medication. What would the risk be then if we were to have unprotected sex?
If you are having unprotected sex with someone who is stable on ARVs and had had an undetectable viral load for over 6 months then the likelihood of infection is extremely small. It might interest you to read the Swiss Statement about this risk.
I would also like to know much on this. Can a woman get HIV from a man on ARVs and with undetectable viral load and with a CD4 count of 800? Let me know this as it worries me too much.