Q and A

Question

If I have unprotected sex with other HIV positive people will I get 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.

113 comments

  1. nokulunga

    i am a 33 yr old female taking arv drugs.and my partner is negative and we normal using protection but not always.He has been experiencing pain on the side im not sure if this has to do with kidney.last week he got severe pain on both side and went to see the clinic and they gave him bactrim and after taking them he experience itchiness from his penis and anus and swollen hands. Iam so depressed if it has to do with me taking arv drugs.Please help me.

  2. Lisa Thorley

    Hi Nosipho,

    Because your boyfriend has a high viral load you are at risk. Therefore, if you do not want to contract HIV you should be using condoms. If this isn’t something that he wants to do, then you need to be prepared to one day test positive.

    Also your boyfriend should be on medication. If he isn’t then his HIV isn’t under control.

  3. nosipho

    hi ,
    i want to ask what is the risk when i have unprotected sex with a father of my child who has a high viral load of 200 000 , though he has it but he looks healthy also i want him to be curcumsised but they cant help him. what is important is how does that affect me as mine is still normal and we’ve sleeping together for the past eight years now. How can i help him and myself because he dont want to use a condom

  4. Lisa Thorley

    Hi Zee,

    Please see the above post and the following link:

    https://i-base.info/qa/10140

    Given that your partner is positive, for their own health, they should be on meds.

  5. Zee

    I am hiv positive on arvs and my patner who infected me does not take arvs but he insists we hv sex without a condom ….could this make me resisitable to my drugs or make me sicker?

  6. Lisa Thorley

    Hi KB,

    The risk of transmission when someone has an undetectable viral load is close to zero. For more info, please see here:

    https://i-base.info/qa-on-the-partner-study/

  7. KB

    If I slept with someone who Is HIV+ yet she Is undetectable for the past 3yrs will I get Infected?

  8. Lisa Thorley

    Hi Gugu,

    Because you’ve been on medication for a year its very likely that your viral load will be undetectable. What this means is that the meds are controlling your HIV. It also means that the risk of you transmitting HIV is close to zero. Please see here for more info:

    https://i-base.info/qa-on-the-partner-study/

    With regards to telling someone about your status, this can be difficult. It is though possible.

  9. gugu

    I’m positive, ,I’ve been on ARVs for also most a year. Is it possible to infect someone with one round of unprotected sex? I am scared of being in relationship because the stigma that come with telling the new partner my status.

  10. Lisa Thorley

    Hi Andy,

    If there is any confusion with your sisters test results, she will need to have her viral load tested. What sort of tests has she had so far, and what has her doctor said?