Q and A

Question

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

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

Answer

Answer: Simon Collins

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

  1. 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).
  2. 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).
  3. 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

  1. Simon Collins •

    Hi

    I can’t explain this result but perhaps your doctor will help.

    It might be that one of these test is wrong – either yours or your wires.

    It is common for one person in a couple to test positive and the other be negative. This often happens if the positive person did not know they had HIV.

  2. Itu •

    Hi i slept with my wife for nine month without a condom and a month ago we found that she is positive and i’m negative, How is that possible

  3. Simon Collins •

    Please see previous answers on this post.

  4. Angel •

    Hi i had sex with my boy friend more then 10 time and he told me he’s HIV positive be he’s CD4 count it high he’s not taking treatment….

    Is it possible that i may be not infected?

  5. Robin Jakob •

    Hi,

    Just to clarify, by goloria do you mean gonorrhea?

    It is possible to have HIV and this at the same time. You are not free of HIV if you have gonorrhea. You would have both.

  6. Layal •

    Is it possible for you to have a HIV or Aids and still contact goloria??? Or when you contact goloria does that mean you are HIV or aids free for that time???…

  7. Robin Jakob •

    Hi Lizzy,

    Many people who have HIV manage to safely have HIV negative children.

    You can find more information here:
    http://i-base.info/guides/pregnancy/becoming-a-mother

  8. lizzy •

    My boyfriend wants us too try having a baby. I’m positive and he is not what should we do?

  9. Simon Collins •

    HIV is not transmitted every time. It sounds lie you have just been lucky so far. If your husband is on treatment this will also have made him less infectious.

  10. Sarah •

    I have 3 children with my partner who is HIV+ we don’t use protection an still I am negative how is that possible? X