Hello, Both my lover and I are poz for a couple of decades each. We're healthy but I'm concerned because he came in me and I don't want a "superinfection", or resistance due to his HIV having a ride in my body. What now? Thank you.

'What now' is that you both explain to your doctors what has happened, and you and your doctor(s) watch for any evidence that a superinfection has occured.

You are right to be concerned. It is now well established that HIV superinfection can occur. Superinfection means that a person with HIV infection can acquire a second strain of HIV and, as you suggest, it is possible that the second strain may be harmful to your current medical care due to ART drug resistance.

In one long term study in a very different setting, i.e. of heterosexuals in Africa, superinfection was observed to occur in 8 of 57 women. In that study the main forms of HIV were Clade C, D, A, and various 'recombinants'. Here in the US, where the majority clade is clade B, superinfection has also been well documented, though it has been more difficult to prove and has occured at a lower frequency than in the above study.

Still, the important take home point for people living with HIV is that you can be superinfected with a different strain of HIV, and there are cases documented in which a persons stable clinical course was disrupted because of the acquisition of a viral strain that was resistant to the patient's current regimen.

So, to repeat myself, I suggest that you each talk to your doctor about this event, your concerns, and this response, so that you can monitor your status closely over the next few months. You will be asked whether you have had any new signs or symptoms, and you will repeat your viral load and CD4 cell count, as well as resistance test if the viral load is elevated.

Finally, I urge you to be safe in future, so you can avoid this uncertainty, and continue to be fully adherent to your ART regimen, so that you can remain healthy.