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
My younger sister had an HIV test last year around November..
And it came back positive and the second one..
So the doctor decided to do the third one the second line was not clear so now she’s confused whether she has the virus or not..
And she sleeps with her partner without protection..
Please help out
Hi Lerato,
How are you coping with your diagnoses? Are you able to get some support? Has medication been discussed with you?
Though your boyfriend has tested negative depending on when you last had unprotected sex, he may have been infected. Therefore he may need to test again. There’s info about testing here, see Q1:
https://i-base.info/qa/what-are-the-most-asked-questions
Hi Lisa
I’m an 19 year old girl who just found out that she’s infected with HIV. I found out on the 3rd of April.
I had to tell my current partner about the situation, we’ve been seeing each other since January….
He went and get tested the same week and the results came back negative and we’ve been having unprotected sex more than 5 times, so will his results change???
Hi Nick,
There’s no reason why you can’t have sex without using condoms if you have an undetectable viral load, and with a partner who is negative. This is because the risk of transmission is close to zero. For more info please see the result of the PARTNER study:
https://i-base.info/qa-on-the-partner-study/
As to why some doctors don’t give people this information, I don’t know. It would help however if they did because you’re right, HIV shouldn’t be a barrier.
With regards to why don’t people test, I really don’t know.
Hello, first I would like to thank you guys for answering all the questions promptly and conciously. Then, regarding a cuestion that is asked many times by a lot of people, if we are hiv positive and both partners are undetectable with no STIs and very serious about treatment, can we have sex without a condom and not worry about reinfection or resistance to drugs and if so, as I presume that the answer will be based on the latest studies that show close to zero chances of reinfection as long as both partners are on medication, why dont the doctors tell you such thing so we can have more intimate and fullfilling sex lives and people just go and check their status more often and stop spreading the virus? Thanks in advance …
Hi Zan,
What your doctor has told you is incorrect, an undetectable viral loads is when it is less than 50 copies. Therefore, if you’re is less than 50, then you have an undetectable viral load. You also have a great CD4 count.
Most ARVs have the potential to cause liver toxicity. Though this is generally rare. If liver toxicity is going to happen the associated drugs are: nerivapine, ritonavir, tupranavir and efavirenz. There’s more about this here:
http://i-base.info/guides/side/liver-related-side-effect
If you do drink excessive alcohol this will impact on your liver. When your doctor said it was, ‘high’ do you know what tests he did? Also what meds are you taking?
With regards to your kidney’s, kidney toxicity is discussed in detail here:
http://i-base.info/guides/side/kidney-toxicity
When you say that your’s is, ‘high’ do you know what test where done? And do you know the results? If you have this information I’ll be able to help you out more.
Though drinking too much alcohol can be a problem for the liver, you being late with your meds won’t impact either your liver or your kindneys.
If your viral load is less than 50 copies, then the risk of transmission to a partner is close to zero. Please see the results of the PARTNER study for more info:
https://i-base.info/qa-on-the-partner-study/
Hello, my Dr says my viral load still isn’t undetectable, so less than 20 my CD4 is 599. I’ve been on treatment for 3 years. He said he’s worried about my liver and kidneys result as they show high. I’m not sure what this means. Does alcohol affect this or sometimes taking my pill late or early affect it.I’m stressed. I also had unprotected sex with my partner, are they going to be infected?
A day after having sex with my girlfriend, I had a feeling she should go for an HIV test which she has not done before and unfortunately she turn out to be positive! I made her do a confirmation test at a different place and it was still positive. Immediately after the confirmation I also did but it was nagetive but the talk I had from the unit I did it was that the virus is undetectable in a short period after sex with an infected person but I couldn’t explain to them instantly due to confusion that I may get it after the three months of my repeat test. Am soo confused and restless right now because I am strongly afraid I may turn out positive the next time I go for the test. Please help me . What should I do now and how quick should it be?
Hi Dave.
i-base don’t answer testing questions. However, please see Q’s 1 and 5 here:
https://i-base.info/qa/what-are-the-most-asked-questions
Hi Sive,
Yes you can have sex. And if other STIs or pregnancy aren’t an issue then you can also have sex without a condom.