If we are both positive, do we need condoms?
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.
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.