Q and A

Question

If I have unprotected sex with other HIV positive people will I get 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.

113 comments

  1. Anonymous

    I had sexual intercourse with a HIV person, he took out the condom and made love to me while I was not aware. He did not cum in me but I’m freaking out still what should I do. What are the chances of me becoming infected.

    Thank you

  2. Simon Collins

    HIV transmission from anal sex (both gay and straight) and vaginal sex is generally not related to blood.

    The tissue in the linning of the vaginal, anus, and the inner foreskin of the penis are called mucous membranes. This is different to skin in that HIV can pass through these tissues.

    If infectious genital fluids – including semen, vaginal fluids and the mucus in the anus, come into contact with other mucous membranes, HIV is able to be transmitted.

  3. Prince

    How do people contact hiv from anal sex because there is no blood contact in the anus?

  4. Simon Collins

    In most cases, the risk from not using a condom when both partners are positive depend on whether either of you are on treatment and whether either of you have drug resistance.

    If you are both on treatment with an undetecable viral load, there is no reason to use condoms, other that to protect against pregnancy and some STIs.

    If neither of you are on treatment, this would also be okay.

    The risk of transmitting drug resistant HIV comes when of you has a detectable viral load on treatment.

    The CD4 count is not directly related to this, but is your partner doing okay in terms of their care?

  5. Ntsiki

    I would like to know what’ll happen if i have unprotected sex with my Partner as we’re both HIV positive. The main problem seems to be that my partner’s CD4 is still low as she get sick more offen and she wants us to have unprotect sex,

  6. Robin Jakob

    Hi,

    There is very little risk here. This is because your husband has already been on treatment for a while. If his treatment is working well he should have an ‘undetectable’ viral load. This means the risk of transmission is extremely small – close to zero.

  7. mbali

    My husband is HIV positive and taking ARV’s. I am negative, its been 4 years now but we accidentally had sex without a condom, how much risk do i have?

  8. Simon Collins

    Please see this link:

    http://i-base.info/qa/10439

  9. vincent lungu

    hi

    I want some feedback from you guys. suppose somebody had unprotected sex with a person who is positive, how long does it takes also him / herself to be positive HIV?

  10. Robin Jakob

    Hi,

    HIV is not transmitted every time you have unprotected sex. It is actually a quite difficult virus to catch. If you now test HIV negative you do not have HIV. You can protect yourself from transmission by using a condom when you have sex.

    You can find more information about transmission here:
    http://i-base.info/guides/testing