Q and A

Question

Can we have unprotected sex if we have the same strain of HIV?

Hi,
I was infected by my (long-term) partner few months ago (we both have good CD4 results and without treatment). We are together for many years and for many years have been practicing unsafe sex together.

As a lot of recommendations say that two HIV-positive people should use condoms to prevent superinfection by a stronger type of virus. I completely understand it in situations when I would like to have an unprotected sex with other unknown positive person. But in our case, when we have both the same subtype of virus, is there a real risk of superinfection and a negative impact on our state if we practice unsafe sex?

It’s a strange feeling after years start using condom between us (or course, with other people we use it every time from when we were diagnosed).

Thank you very much.

Answer

Hello,

Thank you for your question.

If you are infected with the same strain and neither of you has any resistance to HIV treatments then there should be no problem with you continuing to have sex without using condoms.

The main risk from superinfection/reinfection is if one person has resistance to some HIV treatments or a different type of HIV. This sound like it is not the case for you and your partner.  You can check your level of resistance to HIV treatment with a simple test. A resistance test is routinely recommend for all newly diagnosed people in the UK. Please talk to your HIV doctor about this.

10 comments

  1. Josh Peasegood

    Hi Chris, yes this is correct. While your partner is on treatment, HIV is suppressed so much that it becomes undetectable. When this occurs it means U=U can be applied.

    U=U states that when someone is on treatment with an undetectable viral load it is impossible to pass on HIV via sex. It also makes transmission to baby very unlikely (less than 1%).

    More information about U=U can be found here: https://i-base.info/u-equals-u/

  2. Chris

    My partner is hiv positive and i am negative. She jas an undetectable viral load and we practice unsafe sex. We hav 2 kids who are also negative. For more than 4 years, i do my giv test every 2 month and all is going well with us. So sex without condoms is completely safe if your partner has undectable viral load and takes their medication regularly

  3. Josh Peasegood

    Hi James, it is great to hear how well you are doing on treatment. As you are adherent with your medication and have an undetectable viral load, your treatment will prevent further infection from someone else.

    This is called Treatment as Prevention (TaP): https://i-base.info/guides/starting/treatment-as-prevention-tasp

    The only risk is if this person has been on the same treatment as you before and has gained resistance to your treatment, or they originally had an HIV strain resistant to treatment. Though both of these cases are rare and you can still largely rely on TaP. Any further concerns about sleeping with someone who is not on treatment would be recommended to use a condom to prevent any further risk.

  4. James

    I am HIV undetectable and am on treatment. What would the result be should I have unprotected sex with a person who is HIV positive and not on medication?

  5. Josh Peasegood

    Hi Mitchy, I am sorry to hear how your ex partner is treating you.

    As you are undetectable it is impossible for you to have passed on HIV to your partner. When undetectable and on treatment, HIV is suppressed so much in your body that you cannot pass on HIV via sex.

    This is called U=U: https://i-base.info/u-equals-u/

    As you have been undetectable for 2.5 years, this is more than long enough to prove that it was not possible to pass on HIV to your partner.

  6. Mitchy

    I have HIV for 3 years now but I have been undectable for about 2 and half years. I decided I wanted a child and had sex with someone who agreed with me. I made a mistake of not telling him to do a HIV test,I only asked for genotype test. I realized after a while that this is not who I wanted to have a child with and cut him off. After about 8 months he is claiming I infected him. I have had other partners who are negative and none of them have the virus. How do I prove I am not the one who infected him. I am in Nigeria please I need your help as he’s already threatening me

  7. Roy Trevelion

    Hi Phumzile,

    Can I ask if your partner is on HIV treatment (ART)? That’s because, if he’s on ART, and has an undetectable viral load, HIV cannot be transmitted. Even if you don’t use condoms.

    Please see Undetectable = Untransmittable at this link.

    How is your partner’s health. Does he have access to his CD4 count and viral load results. And if he’s taking HIV meds, what meds are they?

    Please let us know. And here’s the link to and introduction to ART. There’s a lot of useful info in this about ART.

  8. Phumzile

    I am HIV positive and my partner is negative. We are not using condoms, what risks am i putting myself in as he is though HIV negative?

    Thanks in advance

  9. Robin Jakob

    Hi,

    The risks of transmission is very low if a positive partner is on. If you have an undetectable viral load the risk of transmission is extremely low – close to zero.

    You can find information about this here:
    http://i-base.info/guides/testing/risk-hiv-status

  10. Khomotso

    Hi,

    I’m HIV positive and on treatment and my partner is negative and we want to practice unsafe sex. How risky it is for us to do that? Will my partner also get infected?

    Thanks in advance.

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