Question
Why do some men prefer to bareback? Is this dangerous?
5 August 2009. Related: All topics, HIV reinfection (superinfection), HIV transmission.
Hello,
First thank you for help and support this website is offering to people who are affected by HIV.
I would like to know why HIV-positive people bareback without any worries? What kind of other infections this can lead to? Does it affect the work of the ARVs and does this limit the future choice of combinations?
I am positive myself and practise safe sex, but most positive guys reject me as I prefer to use a condom.
Answer
Thanks for the feedback which is always appreciated.
Not all HIV-positive men choose to bareback, and many are quite happy to continue using condoms, knowing that this is the safest way to protect their partners and themselves from reinfection or other sexually transmitted infections.
There are many reasons that people choose to bareback though, including desire for closeness, not being reminded of HIV and simply finding it more pleasurable. For many HIV-positive people, this changes their quality of life in a really important way. All these are very valid reasons why some people bareback with other HIV-positive partners.
However, this is an individual choice and you should not feel presurised into doing anything that you are not happy or comfortable with.
To the second part of your question, some people can bareback safely with little or no additional risk. The safest way is for an HIV-positive couple who do not have other sexual partners outside this relationship and when both of the partners have the same type of virus (i.e. with similar drug resistance histories).
Because the risk of transmitting HIV is related to viral load levels, if one or both partners is on therapy with an undetectable viral load, and he/she is adherent, then the risk of reinfection is also likely to be very low.
The risks from barebacking when both partners are HIV-positive include:
1. HIV reinfection, where someone who is HIV-positive is infected again with a new strain. If you don’t know your partner’s HIV treatment history, then the risk from reinfection with a drug-resistant strain of HIV is something to take seriously, as this would affect your own treatment options.
2. Infection with another sexually transmitted disease. Among the most serious are herpes, Hep B, Hep C, syphilis, etc that can make HIV more complicated and difficult to treat.
Finally, it is your right to decide whether to use a condom or not with other HIV-positive partners. If you don’t know your partner’s HIV status, or if they are HIV-negative, then you will want to protect them from catching HIV (as you already do).