Q and A

Question

If we are both positive, do we need condoms?

5 February 2012. Related: All topics, HIV reinfection (superinfection), HIV transmission, Living with HIV long-term.

i am HIV positive and on treatment (ARVs). My wife is also positive but not on treatment. We often use condoms, but once in two months we go ‘unprotected’ when we are without condoms. What are risks associated with our ‘unprotected’ sex? It now appears to be a practice to go without condoms at least once in two months.

Answer

Answer: Simon Collins

Hello,

Thank you for your question.

The main benefit of condoms is to protect against pregnancy and some other STI’s.

So the quick answer is if these are not a concern, it is fine to not use condoms. This is based on what you both prefer.

Actually, many couples say this is one of the few advantages of both being positive.

This is if your viral load in undetectable. If your viral load is detectable though, there is a small risk that your wife could become reinfected with drug resistant HIV.

Does your wife plan to start ART soon? In 2018, ART is recommended for everyone, and if you were both on treatment with undetectable viral load, they would be no risk to either of you.

Drug resistance can happen if you often miss doses of your medication.

There is more information about the risks of reinfection in this guide to HIV testing and risks of sexual transmission.

Note: This answer was updated in February 2018 from a question first posted online in June 2012.

57 comments

  1. Lisa Thorley •

    Hi Lerato,

    If you’re on meds and have an undetectable viral load you can’t transmit HIV to your boyfriend. Please see here for more info:

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

  2. lerato •

    I’m HIV Positive and I’m taking ARVS. My boyfriend and I we’ve been dating for 12 years and we have a baby boy who is now 8 years. My problem is my boyfriend doesn’t want to use condom. Again I’m keeping my status a secret but I think He knows about our status.

  3. Lisa Thorley •

    Hi Amy,

    If you’re both new to treatment the nausea could be a side effect of the meds. If you aren’t then its unlikely to be HIV related.

    Because your partners CD4 is rising, this means that the meds are working.

  4. Amy •

    What could be the possible cause of a nauseas feeling when both HIV+ individuals are having unprotected sex while on treatment?
    Both individuals are on treatment (Artroiza & Trivenz respectively). Upon diagnosis, cd4 count was 841 for one and below 500 for the other. The treatment has seen an increase in the cd4 count of the individual below 500…while the other is waiting on the results.
    Could this possibly mean a decline of the cd4?

  5. Lisa Thorley •

    Hi Doctorlove,

    For information about life expectancy, please see here:

    http://i-base.info/qa/?s=life+expectancy

    When someone is on treatment, if their viral load is undetectable the risk of transmission is close to zero. For more info, please see the results of the PARTNER study:

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

  6. Doctorlove •

    How long can someone who is positive live for? Is it dangerous to have sex with some who is negative, even when you’re on treatment?

  7. Lisa Thorley •

    Hi Busu,

    If he’s been moved to second line, there’s a possibility that his meds aren’t working or he’s having side effects. Has he talked to you about this?
    If he’s having problems with his meds, then yes there is a possibility of reinfection. Please see here:

    http://i-base.info/qa/10140

    It would help to know why he’s having to change, and what his viral load is.