Our expert says:
"My partner and I are both HIV positive. Do we still need to use condoms?"
The answer is a resounding "yes". For years HIV reinfection or superinfection as it is sometimes called, has been theorized as a consequence of unprotected sexual encounters between two HIV infected people. Simply put, reinfection occurs when a person living with HIV gets infected a second time while having unprotected sex with another HIV infected person. It's been proven to be possible in laboratory studies as well as in animals trials. And for years, proof that it could happen in real-life situations has been hard to come by. But now, compelling evidence has surfaced in human case studies that has confirmed our fears that HIV reinfection can occur and can be very problematic for HIV infected people.
So I get reinfected. How does that affect me?
As you may already know there are several strains of HIV. In addition, when exposed to medications, HIV changes or mutates over time. If a person is reinfected with a strain of HIV that is different from the strains already present or if a mutated HIV type is introduced into the body through unsafe sex, treatment will be much more complex and potentially ineffective. For example, I am being treated for HIV and my medications are working well...my viral load is undetectable. Then I have unprotected sex with another person living with HIV and get reinfected with their strain...one that is resistant to most medications. Over time, that new strain will flourish in my body, rendering my once successful treatment useless. Eventually my viral load skyrockets and my immune system pays the price.
What should I do to prevent reinfection?
Simply put, to prevent reinfection, safer sex should be the rule with each and every sexual encounter. Be honest with your partner. Insist on condoms each time and explain why. While some feel condoms "kill the mood" or "don't feel as good" as sex without condoms, it is possible to have a very fulfilling sex life that includes condoms.
What if I have already had unprotected sex?
With your partner, introduce condoms into your intimacy. While it will feel different it can be very pleasurable. Also, continue to take your medications as prescribed without missing any doses. Share your concerns about reinfection with your physician and make him aware that you have had an unprotected encounter with another positive person. With this information, your doctor can be in tune to therapy failures is they occur and possible reasons for that failure. He or she may even feel a genotype resistance test could be helpful.
We all know safer sex practices are the most important way to prevent transmission of HIV to the uninfected population. But now it is becoming clear that HIV infected people can benefit from safer sex as well.
Dr Elna Mcintosh
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