Question
If I have unprotected sex with other HIV positive people will I get resistance?
15 January 2017. Related: All topics, HIV reinfection (superinfection), HIV transmission, 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.
Hi James,
How are you coping with your diagnoses? Are you able to get any support? Is your partner now also on medication? If your partner is on meds and there has been treatment failure, I’d suggest that you use condoms. This is because there is the risk of reinfection. If this isn’t the case, then yes if you choose to have sex without using condoms then you can.
Once you, or both have you have an undetectable viral load there is no risk of transmission through sexual intercourse.
Hi, i am 31 yrs old male diagnosed positive two month ago and on med. Will there be any problem if i have unprotected sex with the partner who infeceted me
Hi Nokulunga,
What is happening to your partner has nothing to do with you taking ARVs. People get ill. The rash is likely to be reaction to the bactrim, therefore he should speak to his doctor.
For reference when someone is on ARVs and has an undetectable viral load they can’t transmit HIV to a sexual partner. For more info, please see here:
http://i-base.info/qa-on-the-partner-study/