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. Busu •

    My partner n l are both positive. And we are both on treatment (1st line). According to my blood results – my viral load is undetected . We started making love last April unprotected sometimes we use protection. We sleep once a month (we stay in different provinces). January this year he was told that they need to move him to 2nd line of ARVs. What could be the problem. And am I at risk/danger if I sleep with him?

  2. Lisa Thorley •

    Hi Nqobile,

    If you don’t have an undetectable viral load, you are risking transmitting HIV to your partner. Even if HIV is now a very treatable health condition, it is still a very serious health condition.

    You choosing not to tell your partner is up to you. However, if you have infected him, even if he didn’t want to use condoms that will be to a certain degree your responsibility. This is because you know your status. Yes, he should also take responsibility for his health, but you know something about yours that he doesn’t.

    Also, just because some guys say he’s positive doesn’t mean that he is. How would you feel if it was the other way around?

    If however, your on meds. If your viral load is undetectable the risk of transmission is close to zero. Please see here for more info:

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

  3. Nqobile •

    I’m hiv positive and I’m having unprotected sex with my partner. I don’t know his status I did tell him to use protection, but he denied. If he’s negative and I infect him will I be wrong for not telling him about my status?? Guys tells me that he is positive though.

  4. Lisa Thorley •

    Hi Selogadi,

    If you aren’t using meds, or if your viral load is detectable then yes. This is because if you don’t you risk transmitting HIV to your partner.

    If you’re viral load is undetectable, then the risk of transmission when not using a condom is close to zero.
    Please see the results of the PARTNER study for more info:

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

  5. Selogadi •

    I’m HIV positive and my partner is not HIV positive I must use condom all the time or not?

  6. Lisa Thorley •

    Hi Wonder,

    There’s no reason why you should use condoms, that is unless one of you was having problems with their medication.

  7. Wonder •

    Hi, my partner and I we are both HIV positive and we’re on ARVs. Does that means we should always use condoms every time we having sex?

  8. Lisa Thorley •

    Hi there,

    Because your partner is on treatment, the risk of them transmitting HIV to you is close to zero. For more info please see the results from the PARTNER study:

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

  9. unknown •

    I’m HIV negative, I’ve been having unprotected sex for 8 months now with someone who is HIV positive. They’ve been on meds for 8 years. Am I at risk?

  10. Lisa Thorley •

    Hi Buyi,

    If you’re on treatment and have an undetectable viral load, the risks are close to zero. Please see the results from the PARTNER study:

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

    If your partner is negative,then you can’t be reinfected.