Q and A

Question

Am I at risk from resistance if my partner is not yet on meds?

Hi. Me and my partner are both HIV positive and we have sex without condoms. I have been taking medication for the last three months, but he has not started treatment yet. Please, will I have drug resistance if I am reinfected by him?

Answer

Hi

Thanks for your question and it is really good that you are aware of drug resistance.

How are you both doing? It is good that you have started treatment and that this is going well.

To give a good answer it would help to know how long you have been together.

Also, do you know if you were tested for drug resistance before stating treatment? This varies defending on the guidelines in your country.

If you were having sex without condoms for a while, especially before you were both diagnosed, it is likely you both already have the same type of HIV. This is especially true the longer you have been together.

This means that even though your partner is not yet on treatment, you would not need to worry about resistance.

Is there a reason that your partner hasn’t started treatment yet? In most countries, HIV treatment is now recommended for everyone who is positive. This might be a good thing to do together as you could both support each other.

There is one other concern though. Most drug resistance occurs when someone on treatment misses their meds or still has a detectable viral load. This mean you will need to be good at taking your meds now. It also means that if your partner does start treatment he also need to not miss doses.

The risk of resistance is probably bigger if your are both on meds but one of you still has a high viral load. This is when resistance can develop and when there is a chance that resistance from one of you could pass to the other.

14 comments

  1. Josh Peasegood

    Hi Blanca, I am sorry to hear you have just found out about your status. Have you been able to talk to anyone about this?

    Yes, your medication will work. Resistance is usually only a problem for people with poor adherence to their medication – meaning they do not take it properly. It is possible to have a resistant strain of HIV prior to starting medication but this is very rare.

    You are right that if an HIV test is done too early, the result will be negative. Do you know how your boyfriend feels about HIV and if it will be safe to tell him? This will allow for a conversation about him testing. Now that you have started medication, it should be soon that your viral load becomes suppressed and will be unable to pass on HIV: https://i-base.info/u-equals-u/ In the meantime, are you able to use condoms? or would your boyfriend be open to taking PrEP? https://i-base.info/guides/prep

    Being HIV positive does not mean that you will pass on HIV to your boyfriend if you have not used a condom. The difference is that a condom will guarantee that HIV is not passed on. There are a number of factors that change the risk of transmission e.g., position in sex and genetics.

    As you tested a month later, unless you can identify the time at which HIV was passed on to you, it can be difficult to determine who gave HIV to who in your relationship – if at all.

  2. Blanca

    Hello, I tested positive February 22 of this year and my boyfriend tested negative in January of this year as well… by the time I tested positive we had been together for 4months and never used codom because we had been looking to have a baby.
    I have not tell him about my status but I started my medication 2 days ago… now I read about how the teste can come (negative) if it’s done early, and I am scared that I may have infected him and that because he did his test 3months after we started having sex it came out negative… also now that I have started my medication, are they going to work? Or I will get resistance or reinfection in case that he’s (+) and we don’t know yet. I am scared to tell him to do another test

  3. Lisa Thorley

    Hi Palesa,

    As the post above explains, if you both have the same strain of HIV, there’s no risk. Do you think this might be the case?
    Though your partner isn’t on medication (which isn’t ideal for their health) it’s good to hear that you’re using it.

  4. Palesa

    Good day

    I have just started taking my HIV medication however my partner doesn’t want to take it … we have unprotected sex all the time . I make sure I don’t miss a dose so I just need to know if we are reinfecting each other or because I take my meds correctly we kinda safe?

  5. Roy Trevelion

    Hi Musa,

    We are not doctors at i-Base. And it sounds like your doctor is giving you good advice. Please talk to your doctor about your body weakness.

  6. Musa

    Good morning,the reasons why i confused about hiv,some say if pep fail to prevent hiv him would exten hiv window period to six months before you would test hiv positive in blood test,That is why i so confused about the body weakness the doctor dat give me pep said my hiv test results is conclusive at 45days of pep in 4th generation hiv test i didn’t have hiv but i refuse to agree with what him , i test hiv negative 11 time from exposure to four months of exposure

  7. Roy Trevelion

    Hi Musa,

    Please talk to your doctor about your symptoms. You can explain them in detail and tell them what your body weakness is, and what it feels like. You can discuss what other reasons there might be for your symptoms other than HIV.

  8. musa

    why i still have body weakness as i test HIV negative 11 time, now four months of exposure i take PEP for one month within 24hour of exposure,i think my symptoms is HIV symptoms, i confuse about the symptoms but i test HIV negative 11 time with 4th generation HIV test five time from from 45 days to 105 days of PEP

  9. Roy Trevelion

    Hi Musa,

    This looks like you’re HIV negative. It’s good that your partner had been on HIV treatment (ART) for more than two years. And if viral load was undetectable then the risk to you was zero.

  10. MUSA

    Good morning Sir/M,i’m sorry for distop these website i felt anxious for good four months i still need help from these website,condom break as i put my penis inside her vagina without ejaculation,the woman start treatment more than two years befor dis accidents occur,i start pep within 24hour of exposure without miss a single drugs for one month,i did hiv test eleve time all are negative, 4th generation hiv test at 45,66, 75, 82, 105 all are negative,3th generation at 38,60,90, 98,118 all are negative, i have severel body weakness till today

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