Q and A

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

Answer: Charlotte Walker

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. Bianca •

    Hi guys if a woman is HIV positive and is on treatment can she infect her partner if he is negative?

  2. Lisa Thorley •

    Hi Sandile,

    For how HIV is transmitted please see Q1 here:

    http://i-base.info/qa/what-are-the-most-asked-questions

    If the person is on treatment and has an undetectable viral load the risk would be close to zero. Please see the results of the PARTNER study:

    http://i-base.info/qa-on-the-partner-study/

  3. Sandile •

    if u had an unprotected sex with someone who is positive but during sex there were no blood present, what about that?

  4. Lisa Thorley •

    Hi tiisetso,

    How are you doing since you started meds? Is you CD4 recovering well? And what is your viral load?

    Because your boyfriend is having sex with other women and may not be using condoms, there is a chance that he may contract other STIs. If this happens and you have sex without a condom, you may contract these STIs. This is unlikely to affect your HIV. However, it could affect your health. This is something to be cautious about.

    With regards to your boyfriend not adhering to his medication, this could cause resistance to happen. This may lead to reinfection.

  5. tiisetso •

    I found out that I’m HIV positve in 2012. I went into denial and deiced not to take treatment hoping that the result would change one day. However, early last year, 2016 I started to get sick and went to the clinic and re did the test. It turns out that I was still positive, and my CD4 had dropped drastically. I decided to make peace with it and began taking meds .

    Now my worry is that my boyfriend was the first to take ARV’s now he doesn’t take them daily like he used to, he thinks he is strong. He is sleeping with other women and I’m not sure if he uses condoms. Will this affect me?

  6. Lisa Thorley •

    Hi Thabo,

    You may wish to use a condom when having sex with your wife until you’ve finished PEP and also done your HIV tests.

  7. Thabo •

    I like to ask, I’ve got a wife we both HIV negative I had one night with someone who is HIV positive the condom burst while having sex. I went to the Dr now am drinking Trivenz,can I have sex with my wife while I am still on treatment?

  8. Lisa Thorley •

    Hi Klass,

    Taking tribuss when not knowing if you are HIV positive or not is dangerous. You could be risking your health when not necessary. You need to have a HIV test done. If you are positive, you will be prescribed free ARVS, as they are free in South Africa.

    Splitting doses with your wife could also be seriously affecting her health because ARVs are supposed to be taken daily. Though there is some research that states that you can take tribuss less.

    With regards to why you are losing weight, I don’t know. But if you are HIV positive and have a low CD4 count this could be the reason. You having sex with your wife will neither make her gain weight, or you lose it.

  9. Klaas •

    I have not tested, but find my wife’s been on tribuss since 2015. I recently started joining her after we where both treated for an STD. What worries me is, she gains weight while I loose it. Luckily she has tested, but I haven’t. I am though using tribuss as she is sahring her packet, since I am not employed.

    I have lot of appetite and we are still sexually active, but without protection will this be the cause of my weight loss or not?

    Regards,

  10. Lisa Thorley •

    Hi Audney,

    If the person has an undetectable viral load the risks are close to zero. Please see:
    http://i-base.info/htb/30108

    For information on testing and transmission see question 1:
    http://i-base.info/qa/what-are-the-most-asked-questions