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When you're both HIV positive

relationships

Relationships where both partners are HIV positive are sometimes called ‘seroconcordant’.

Some people with HIV prefer to have relationships with other HIV positive people. It might seem simpler and feel more comfortable when a partner knows what it’s like to have HIV.

However there's no reason to be put off having a relationship with someone who is HIV negative - if you're on treatment and have an undetectable viral load you cannot pass on HIV.

It can take up to six months for your viral load to become undetectable - so effective treatment means that someone has been taking it as prescribed for at least six months and has an undetectable viral load.


Is re-infection something to be worried about?

Re-infection is when:

  • you’re HIV positive,
  • you have unprotected sex with another person with HIV
  • one or both of you has a detectable viral load
  • and pick up (or pass on) a different strain of the virus.

This can be a problem if one person’s strain is resistant to particular antiretrovirals.

This used to be more of an issue when we understood less about the link between viral load and infectiousness. We now know that if you’re taking HIV medication and have an undetectable viral load you can’t pass on HIV.


HIV medication and infectiousness

In the UK, national guidelines currently recommend that anyone with HIV who is ready to commit to treatment should start it regardless of their CD4 count.

This means more people will be on treatment sooner and will have an undetectable viral load. This means they cannot pass on HIV - so although reinfection is a theoretical risk, it’s unlikely.

If you had drug resistant HIV your viral load would be more likely to be detectable, which you would be aware of, meaning you could use protection to avoid the risk of re-infection. If you have an undetectable viral load, this means you aren’t resistant to your medication.

If you have a detectable viral load or don’t know whether the person you’re having sex with is undetectable, using a condom will prevent the theoretical risk of re-infection.


Other risks

Another issue to consider is that if you have sex without a condom there is a chance you’ll pick up a sexually transmitted infection (STI).

STIs such as herpes, syphilis, gonorrhoea, chlamydia and hepatitis C can interfere with your HIV treatment and make you more ill.

Sex without a condom can also result in an unplanned pregnancy if other contraception is not being used.


Monogamy and open relationships

You and your partner should talk to each other and agree whether your relationship will be monogamous (no sex outside the relationship) or ‘open’ (sex with others allowed).

There are risks in not discussing it and assuming that your partner agrees with you. Some people who think they’re in a monogamous relationship find out that their partner has had sex with others.

Both monogamous and open relationships can bring benefits and challenges. For example, some couples in monogamous relationships say they enjoy feeling both physically and emotionally committed to only one person. However, they may feel frustrated if they have a higher or lower sex drive than their partner.

Some couples in open relationships say they enjoy the sense of freedom and variety it can bring, but it can also highlight any feelings of jealousy or insecurity within the relationship. Mutual trust and honest communication are vital in both monogamous and open relationships.

If you both agree to be monogamous it’s important to discuss what would happen if either of you broke this agreement. If either of you feel that you must hide the fact that you’ve had sex outside the relationship, that can seriously threaten your relationship.

One advantage of monogamy is that no STIs are likely to come into your relationship.

Using condoms with people outside your relationship will make it less likely that you’ll pick up infections (and give them to your partner) although some STIs can be passed on despite using condoms and through oral sex.

If you’re planning to have sex with HIV negative partners you could pass on HIV if you do not have an undetectable viral load.


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More information for couples affected by HIV:

 

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2 comments

  • The most important thing is to realise that it is not end of the world.

    Posted 18:30 Thu 12 Sep 2013
  • Good morning
    Hello
    My self ami m HIV positive boy
    my question is
    What effect in my body if I get marry to HIV positive girl
    Is anything change in my blood or body or health ?because
    Right now my cd4 count 638 and viral load found undetected
    Physically m slim and well not having any other problem
    Let me know please

    Posted 10:58 Thu 07 May 2015

The Information Standard: Certified member

This article was last reviewed on 25/1/2017 by Anna Peters

Date due for the next review: 25/1/2020

Content Author: R. Scholey

Current Owner: Kerri Virani

More information:

HIV Transmission Risk Persists During the First 6 Months of Antiretroviral Therapy, Mujugira A1, Celum C, Coombs RW, Campbell JD, Ndase P, Ronald A, Were E, Bukusi EA, Mugo N, Kiarie J, Baeten JM; Partners PrEP Study Team
National Center for Biotechnology Information
US National Library of Medicine
2016 Aug 15;72(5):579-84. doi: 10.1097/QAI.0000000000001019

HIV treatment as prevention and HPTN 052, Cohen MS1, McCauley M, Gamble TR
National Center for Boiotechnology Information
US National Library of Medicine

Is reinfection a risk if two HIV positive people are undetectable?, Simon Collins, HIV i-Base, September 2014

Viral load and transmission, a factsheet for people with HIV, Gus Cairns, NAM aidsmap, September 2015

Viral load and transmission, a factsheet for HIV negative people, Gus Cairns, NAM aidsmap, September 2015

Reinfection, STIs and viral load, NAM aidsmap

Hepatitis C, i-base (2009)

Redd A et al. Next-generation deep sequencing reveals that the rate of HIV superinfection is the same as HIV incidence in heterosexuals in Africa. 19th Conference on Retroviruses and Opportunistic Infections, Seattle, abstract 58, 2012.

Ronen K et al. Detection of frequent superinfection among Kenyan women using ultra-deep pyrosequencing. 19th Conference on Retroviruses and Opportunistic Infections, Seattle, abstract 59LB, 2012.

PARTNER study, NAM


Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy, Journal of the American Medical Association: Alison J. Rodger, MD; Valentina Cambiano, PhD; Tina Bruun, RN; Pietro Vernazza, MD; Simon Collins; Jan van Lunzen, PhD; Giulio Maria Corbelli; Vicente Estrada, MD; Anna Maria Geretti, MD; Apostolos Beloukas, PhD; David Asboe, FRCP; Pompeyo Viciana, MD1; Félix Gutiérrez, MD; Bonaventura Clotet, PhD; Christian Pradier, MD; Jan Gerstoft, MD; Rainer Weber, MD; Katarina Westling, MD; Gilles Wandeler, MD; Jan M. Prins, PhD; Armin Rieger, MD; Marcel Stoeckle, MD; Tim Kümmerle, PhD; Teresa Bini, MD; Adriana Ammassari, MD; Richard Gilson, MD; Ivanka Krznaric, PhD; Matti Ristola, PhD; Robert Zangerle, MD; Pia Handberg, RN; Antonio Antela, PhD; Sris Allan, FRCP; Andrew N. Phillips, PhD; Jens Lundgren, MD
JAMA. 2016;316(2):171-181. doi:10.1001/jama.2016.5148

Viral load and transmission, a factsheet for people with HIV, Gus Cairns, NAM, Aidsmap, Sept 2015

Viral load, Michael Carter, Greta Hughson; NAM, Aidsmap, March 2014

More confidence on zero risk: still no transmissions seen from people with an undetectable viral load in PARTNER study, Gus Cairns, NAM, Aidsmap, July 2016

Open your eyes to STIs, NHS Choices, Nov 2015

When sex goes wrong, NHS Choices, Nov 2015

BHIVA guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2015, Writing Group: Duncan Churchill Chair Laura Waters Vice Chair N Ahmed, B Angus, M Boffito, M Bower, D Dunn, S Edwards, C Emerson, S Fidler, †M Fisher, R Horne, S Khoo, C Leen, N Mackie, N Marshall, F Monteiro, M Nelson, C Orkin, A Palfreeman, S Pett, A Phillips, F Post, A Pozniak, I Reeves, C Sabin, R Trevelion, J Walsh, E Wilkins, I Williams, A Winston

START trial finds that early treatment improves outcomes for people with HIV, Gus Cairns, NAM, Aidsmap, May 2015

New British guidelines recommend treatment for everyone living with HIV, Keith Alcorn, NAM, Aidsmap, June 2015

START trial provides definitive evidence of the benefits of early HIV treatmentLiz Highleyman, Produced in collaboration with hivandhepatitis.com, NAM, Aidsmap, July 2015

You and your partners HIV status, HIV i-Base, June 2016

Reinfection, NAM, Aidsmap

Further information on the current risk of re-infection/superinfection taken from discussion with Dr Michael Brady.