Q and A

Question

I want to use condoms sex with my husband because I worry about drug resistance

I’m Gina, I was infected by my hubby 2 years ago. I found out when going for an antenatal check. We are on medication but he always wants to have unprotected sex with me which I don’t want. Sometimes he misses a dose and I always have to remind him. I fear reinfection and drug resistance. We don’t know our viral load.

Answer

Hi, how are you doing?

Sex should always be something that both partners want to do. This is not just the things you do together but the about trust for looking after each others sexual health.

If there are things you are not happy about, then you will not be enjoying the sex. You will be stressed and worrying. If is not listening to your concerns, it is difficult to trust him during sex. This doesn’t make for good sex.

If you only want to use condoms because of reinfection, would you feel different if there isn’t a risk of reinfection?

You are right that it is possible to be reinfected by a second strain of HIV, but this risk is usually small. But most of the time, reinfection will not affect your health. It is only important is the new infection includes drugs resistance.

The risk of reinfection is also related to viral load. For example, if you both have undetectable viral load, then reinfection is not a risk. So in this case, you don’t need to use condoms.

So the first questions are:

  • Do you know your husbands viral load?
  • Do you both take the same medication?
  • How often does he miss his medication?

It is good to worry if he sometimes forgets his meds. But is this is only once every week or two, his viral load will probably stay undetectable, especially if it has been undetectable for a long time.

But the risk of reinfection becomes serious if his viral load is detectable and high on treatment. This is because he is likely to now have drug resistance. In these circumstances, reinfection could cause your treatment to fail. In this case, using condoms is good idea.

A few more questions:

  • Is there a reason he has trouble taking his medication daily?
  • Is there something you can do to help with this?
  • Maybe using an alarm or using a pill box. You can build this into your daily routines.

Finally, does your husband understand the risks for both himself and you if he develops drug resistance?

A final question is to check that the use of condom is only for the prevention of reinfection? You will need to use a condom if you are wanting to prevent other STD’s from other partners.

Josh.

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