Q and A

Question

We are both positive and had unprotected sex – what are the risks?

My partner has been on treatment for almost a year and I am also HIV positive but not on treatment. We ran out of condoms and we had unprotected sex. What are the risks involved and what can we do to minimise the risks?

Answer

When both partners are HIV positive the main reasons to continue using condoms are to protect against other STIs or pregnancy. The risk of reinfection is low and is only a worry if one partner has drug resistance. The risk of reinfection is likely to be as low as the original risk of HIV infection itself.

The lower your and your partner’s viral loads are  the less likely reinfection is to take place.  The risk if it does take place has to do with any resistances you or your partner may have. This resistance can be transmitted. If neither of you have any resistances, or if you have the same ones, then there is unlikely to be any risk to having unprotected sex with each other.

If you and your partner have never been tested for resistance you can ask for this at your clinic.

For many HIV positive people, the positive benefit of being able to have sex without a condom outweighs the generally very low risk of resistance. So long as you are not worried about pregnancy or other infections, or one of you has a detectable viral load on treatment, the risk from not using a condom is generally low. This has to be both your choice though

You can find information about reinfection in out testing and transmission guide.

14 comments

  1. Lisa Thorley

    Hi Mac,

    As you’ve both got the same strain of HIV, there is no worry about reinfection. If you’ve been on meds for 2 months it’s very likely that your viral loads are already low.

    If one of you does develop drug resistance then this could be transmitted to the other partner. If you are both good at taking meds and not missing doses, drug resistance is very unlikely to be a problem.

  2. Mac

    Hi everyone i have one queation.
    Me and my partner are both hiv postive and its same because one of us got infected Hiv and pass to another one so it is same hiv ! We are both on treatment less than two months and i still we have viral loads and not sitll undetectable! So we ran out of condome and having sex with other unprotected once so the question is we had risk or not !!! I couldn’t sleep throught last night and i am worry if there is a problem or not!

  3. Roy Trevelion

    Hi Tuyo,

    The two main risks from not using a condom are pregnancy and other STIs.

    If these are not a concern for you, then there is no risk. This is mainly because having an undetectable viral load on treatment makes you so dramatically less infectious that HIV transmission becomes zero risk.

    Please see this updated Q&A.

  4. Tuyo

    Me and my girlfriend has been having unprotected sex for the past 3minths now. Our both viral loads are less than 20 which I think it’s cool as undetectable.

    My question is… Can either of us have reinfection? Because we are both less than 20 viral load.

    Also, is it possible reinfection occurs in any case since we are still on our Meds?

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