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Sex between HIV–positive couples

From Treat Yourself Right • 25 June 2009

Whether or not to use condoms and lube if your partner is also HIV positive is a matter of personal choice.

Condoms provide the only really effective barrier against HIV and against sexually transmissible infections including the spectrum of warts virusesA small infective organism which is incapable of reproducing outside a host cell. that can cause pre-cancerous and cancerous cells in the cervix. Women with HIV are more susceptible to pre-cancerous changes, so this is an important consideration, especially if a male partner is or may be sexually active with others.

In instances where both partners are HIV positive and neither of you is having sex outside your relationship, you may prefer not to use condoms at all for contraception. This does involve some risks.

There have been some documented cases of ‘super-infection’, where a person already HIV positive gets infected again, with a new strain[HIV strain] Any subgroup of the HIV species. Because HIV mutates very easily, there are many different strains (and may be multiple strains within a single person). of HIV by his or her sexual partner, which might hasten disease progression. There are a handful of cases in the scientific literature where superinfection is proven to have occurred, and as detection of superinfection is quite complex, some experts believe it happens more frequently although there are no data to support this. Superinfection has not been documented when couples are taking treatment, but there is a concern that if it did occur, people could transmit drug-resistantHIV which has mutated and is less susceptible to the effects of one or more anti-HIV drugs is said to be resistant. strains of HIV that could have serious health consequences. It has been theorised that superinfection is most likely to occur shortly after seroconversion, but again, this has not been proven.

In a nutshell, it is possible that condomless sex between people with HIV carries some risk (which can’t be quantified), but it’s likely that if both are on HIV treatments that suppress viral loadA measurement of the quantity of HIV RNA in the blood. Viral load blood test results are expressed as the number of copies (of HIV) per milliliter of blood plasma. to undetectable levels that the risk is minimal.

Treat Yourself Right

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This Resource was first published on 25 June 2009 — more than four years ago.

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