Question

Can I have sex with someone who is positive and not catch HIV?

16 January 2018. Related: All topics, HIV transmission.

Answer

Yes, there are lots of ways to make sure HIV is not transmitted during sex.

One of the easiest and most effective ways is just for the HIV positive partner to be on treatment. An undetectable viral load makes HIV untransmittable. (See: The evidence for U=U).
Another relatively recent option is for the negative partner to use PrEP. This is an oral drug that when taken as prescribed is highly effective. (See: UK guide to PrEP).
You can use condoms which are an effective barrier against HIV (and other STIs). Condoms need to be used carefully, preferably with plenty of lube. (See: How to use a condom (male and female).

HIV is a much less infectious virus than many other sexually transmitted infections (STI’s).

Even without a condom, the risk from a single exposure is less than, for example, 1 in 300. The actual risk becoming infected varies depending on many factors. These include the type of exposure, whether the other person is HIV positive, how high or low their viral load is, the duration and roughness of the sex etc.

If the partner is HIV positive, then viral load is the most important factor. The PARTNER study reported zero HIV transmissions after 900 couples had sex more than 58,000 times WITHOUT condoms. In this study undetectable viral load was defined as being less than 200 copies/mL.
https://i-base.info/qa-on-the-partner-study

Risk factors for penetrative sex without a condom with someone who has a very high viral load could be as high as 1 in 10 (10% risk). But the risk is effectively zero with someone who is taking treatment and who has an undetectable viral load.

This question was updated in January 2018 and November 2016 from an original answer posted in June 2007. i-Base no longer answers individual questions about HIV transmission and risk. (See: Question 1 at this link).

209 comments

Lisa Thorley • 7 December 2016

Hi Winnie,

If your boyfriend is on medication and is undetectable then the risks of transmission are close to zero. Please see the PARTNER study research:

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

If he isn’t on medication and his viral load is detectable then you are at risk of infection. That is unless you use condoms.
winnie • 7 December 2016

i have a boyfriend who Hiv position we aren’t using condoms anymore. I’m scared that I might get infected with the virus. help reply so soon please
Lisa Thorley • 5 December 2016

Hi Roxxy,

I’m sorry that you’re having a hard time especially as HIV is now a very manageable illness. Is there anyone that you can talk to? A friend, family member or a support group? Does your husband offer you any support?

If you’re worried about transmission, you might want to know that if you’re on treatment then the risks of transmission are close to zero. You being on treatment is protection in itself. Please see the PARTNER study:

http://i-base.info/htb/30108

I can’t really comment on your sex life. However, you should only do things that you want to do. And that you feel comfortable with.
Roxxy • 5 December 2016

Hi all
Since I’ve met this guy w got married and we had unprotected sex.I got pregnant in 2014 and got tested only to find out that m positive I was so heart broken my partner tested twist but he was negative,and b4 that we used to have sex until I bleed sometimes,I still do not get it how I got this diagnos I hate my self.M on treatment if we do not have condoms I have do to things that I never do by mustebating him until he …..
M not happy at all
Lisa Thorley • 24 November 2016

Hi Lebza,

The risk of transmission if you have an undetectable viral load is close to zero. Please see the results from the PARTNER study for more info.

http://i-base.info/htb/30108
lebza • 24 November 2016

I’m HIV positive and have an undetectable viral load. Can I infect my negative partner if we don’t use condoms?
Simon Collins • 18 November 2016

Hi Thommy, yes, of course. Please see the full answer at this link:
http://i-base.info/qa/121
thommy • 18 November 2016

Can i have sex with a person who is positive?
balkrishan • 15 November 2016

Excellent
Lisa Thorley • 8 November 2016

Hi kholo,

Having a CD4 count of 480 is not an indication that someone cannot transmit HIV. In this situation, what is important is there viral load. If your partner has an undetectable viral load, then the risks are close to zero. Please see the results from the partner study:

http://i-base.info/htb/30108

However, the only way to know if you have contracted HIV is to test.