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. Roy Trevelion

    Hi Priscilla,

    I’m sorry to hear you’ve just found out you’re HIV positive. But things do get easier in time.

    Have you started HIV treatment? What does the doctor say about starting treatment. But it’s good to know that very many people who are HIV positive and on treatment (ART) can live long and healthy lives.

    Here’s a guide called Introduction to ART. There’s a lot of helpful info in it.

  2. Priscilla

    Last week I found out that am hiv positive and I told my family that I have a kidney disease so in case I get sick.and I love my boyfriend at the very same time I hate him for infecting me

  3. Lisa Thorley

    Hi Lisa,

    This is something that you need to talk to a doctor about. You being positive won’t have any impact on your fertility.

  4. Lisa

    hi
    I would like to ask I am positive and taking my pills and my boyfriend he is not and we trying to have baby and is difficult for us to catch and think it’s because my breast is liking milk for is now over 7 my breast liking and I went to the doctor they said is nothing to worry but am worried cause I think this has effect on my body not to fall pregnant

  5. Lisa Thorley

    Hi Phulma,

    If your viral load is above 50, then no you shouldn’t be having sex without a condom. If you do you risk transmitting HIV to sexual partners.

    Do you know why your viral load is increasing? Are you adhering to your meds?

  6. phumla

    my viral load is increasing can I continue with unprotected sex?

  7. Lisa Thorley

    Hi Charles,

    Yes its ok to have sex without using a condom as its very likely that you’ll have the same strand on HIV.

  8. Charles

    My wife and I have just been diagnosed with HIV. We’re both on ART. Can we have sex without using a condom?

  9. Simon Collins

    Hi Petronella, please see Q9 here:
    http://i-base.info/qa/what-are-the-most-asked-questions

  10. Petronella

    We are both positive me and my partner im taking arvs he is not my cd4 count was last 253

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