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. mama •

    Hi, I am pregnant and taking treatment, how safe is to my child having sex without condom, my partner not on treatment.

  2. Robin Jakob •

    Hi,

    You can find an answer to a similar question here:
    http://i-base.info/qa/9869

  3. emmanuel •

    Suppose both partners in a relationship are infected with HIV, is it important to use a condom during sexual contact?

  4. Simon Collins •

    Hi lebohang

    If you are both positive, then the only reason to use condoms are is you are worried about either pregnancy or other STIs.

    Although you can each be reinfected with a different the other persons strain of HIV, you may already have the same strain of HIV anyway.

    There isn’t any good evidence that not using condoms with have any bad impact on your health, especially if you are both happy to do this.

  5. lebohang •

    Hi me nd my husband we normally have unprotected sex nd we r both HIV positive but not on meds so my question is does having unprotected sex making us both to be in risk to be ill or either hav ada opportunistic diseases?

  6. SLU •

    Thank you.

  7. Simon Collins •

    I am not sure what you are asking for help about. Are you are asking about risks to your health from not using a condom. These are mainly pregnancy and risk of sexually transmitted infections. If your partner has drug resistance there is a small chance that you could be reinfected with drug resistant HIV. If you are happy with these risks then many HIV positive people find that not using condoms in a relationship can contribute to their quality of life. This often includes an agreement to use condoms if either partner has sex outside with other partners. If you are not happy with these risks, then this is something to talk about with your boyfriend.

  8. SLU •

    i am having a challenge and in need of help…..I have been on Atripla for some time now more than a year… my partner is also positive but not on meds yet… we lately are having sex without a condom and it is becoming a habit… my CD800 and VL undetectable. we are both living a healthy lifestyles and i am adhering to my meds always.

  9. Rebecca McDowall •

    Hi Slu,

    Why do you think you might be resistant? I see from our old emails that you started taking Atripla about a year ago- how are you getting on with your treatment?

  10. SLU •

    WHAT HAPPENS THEN TO YOU THE PERSON WHO IS ON DRUG ALREADY ?CAN I BE RESISTANT?