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super or re-infection
Aug 28, 2003

I have heard mixed information regarding re-infection or superinfection and was just looking for some clarification. Is it true that since I am positive that i already carry, in varying amounts, all the varieties of hiv strains. I am not looking to engage in unsafe sex but I'm a little confused and worried about the risk of worsening my condition. I have not started a haart regimen, my hiv specialist has suggested that my labs are showing the potential for me to be a slow or long-term non progessor. I was infected in March of this year but my 's are all normal and cd4 950 vl 3200 I have also heard that the risk of my contracting other social/sexual diseases is higher now that I'm positive. Is there truth to that? I haven't had sex in months and it's beginning to make me feel worse. I really miss the physical contact (not just sexual) but since I feel like I would have to disclose to a potential sexual partner, the fear of rejection is adding to my anxiety. I would appreciate any insight you might have into my situation.

Response from Dr. Remien

You are asking a number of questions here - all are common issues and concerns for most people living with HIV. It is not true that because you are infected "you already carry all the varieties of HIV strains." Most people are infected with one strain of virus upon initial infection, although it is possible to be infected with more than one strain at the outset. What happens with time, is that the virus changes (mutates) as it reproduces. This is a natural process. Sometimes the virus changes very little, within a person, and sometimes it changes a lot. While there is some controversy regarding how likely it is that a person can be infected again (re-infection) with another strain of virus, it can happen. Since your body is handling "your" virus very well, you do not want to introduce another strain of virus into your system because your body may not be able to handle that strain as well. It is good news that you are showing the signs of being a "long-term non-progressor," however it is important that you get regular check-ups with your doctor to make sure that doesn't change, because even though your viral load is relatively low, it is still reproducing in your body.

Yes, there is evidence that having HIV can raise the likelihood of contracting another STD. This is also a complicated issue, but the simple way of thinking about it is that your immune system is already battling one disease, which makes it vulnerable to other infections. But again, there are differences of opinion about this, and some experts would say that with or without HIV, people are equally vulnerable to getting STDs, if exposed, when they have unprotected sex.

In my opinion, there is really no good reason for you to NOT be having sex. With or without HIV, sex is an important part of most peoples' lives. While disclosure of HIV status can be a very challenging thing, it is often recommended that people do it, for their own psychological well-being, and so that sex partners are informed. The bottom line however, is that using protection (i.e., condoms and other barrier methods) prevents the transmission of HIV. Most people living with HIV are able to have satisfying and safe sex with their partners. If issues around disclosure and having a satisfying sex life continue to be challenging for you, I recommend that you speak with a counselor about this. I think you would find it tremendously helpful.

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