Reinfection and other poz/poz sexual health issues

When two positive men get together the question of whether to remove condoms from the scene will often arise. Many positive men do not use condoms with other positive partners. Following is a review of some issues to consider and how to minimise risks.

Reinfection

For some time there has been debate about what risks are posed to positive men by exposure to different strains of HIV, and whether such exposure can result in ‘reinfection’ i.e. acquiring a new and different strain of HIV from someone else (also referred to as ‘superinfection’, where someone is infected with more than one type of HIV).

The presumed risk to an already positive man from reinfection would be the possibility that acquiring a drug resistant [1]HIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant. strain may result in more rapid damage to the immune system, limit future treatment options and/or affect success on current treatments.

Despite this debate, however, there is little evidence about whether it is possible to get reinfected with another strain of HIV; it is considered to be a rare event.

If your partner has resistant virus [2]A small infective organism which is incapable of reproducing outside a host cell. then you should talk to your doctor about your respective treatment histories and risk reduction strategies.

If neither partner has drug resistance the risk, though not known, is probably very low.

Hepatitis C

Although Hepatitis C is not generally considered to be a sexually transmitted infection, recent studies have suggested that under some circumstances Hepatitis C may be sexually transmissible.

Sex involving the transfer of blood with someone who is co-infected (where someone has both HIV and Hepatitis C) may increase the risk of sexual transmission of Hepatitis C.

Blood: Transmission of Hepatitis C is through blood to blood contact. Most Hepatitis C infections have been the result of sharing needles or other injecting equipment, or receiving a blood transfusion. Some types of sex, like fucking without lube, some types of S&M that result in bleeding, or sex with women during menstruation may create increased risks of Hepatitis C transmission.

Co-infection: About 10% of Australians with HIV are co-infected with Hepatitis C. HIV can lead to periods where the amount of Hepatitis C virus in someone’s blood is increased, thus increasing the risk that they may pass on Hepatitis C.

If you or your partner is co-infected, you may wish to talk to them and to your doctor about strategies to reduce risks. This may not need to go so far as using condoms for anal sex (between two HIV positive partners), but should consider risks from any sex involving blood being present.

Sexually transmitted infections

Fucking without condoms can increase your risk of exposure to other Sexually Transmitted Infections (STIs [3][Sexually Transmissible (or Transmitted) Infection] Infections spread by the transfer of organisms from person to person during sexual contact. Also called venereal disease (VD) (an older public health term) or sexually transmitted diseases (STDs). ). Most STIs can be treated but some can be more difficult to treat when you have HIV. Some of them (CMV and KS for example) can become serious opportunistic illnesses in people with advanced HIV disease.

While in some cases anti-HIV treatment may minimise the impact of the STI, in others the treatments will cease to contain HIV from multiplying while the body fights this new infection.