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unsafe sex and how drug resistance happens
Mar 29, 2008

my question is me and my bf both have hiv he got it from me what i like to know is im on HIV meds and hes not i was on atripla and got token off it cause it mad me to sick my bf had a genotype when i was on atripla and he is resistance to one of them and not sure which 1 if we have unsafe sex could i become resistance to the new drugs im taking while im taking them and i am the 1 that receives all the time if i don't bleed and if he pulls out how would it happen i don't understand if there was no fluids swapped we both have herpes and hpv to if that makes any difference thanks and i hope my question was not to difficult to under stand thanks

Response from Dr. Sherer

Yes, you and your boyfriend can exchange each other's HIV, and so exchange a wild type virus for a virus with some drug resistance mutations, like your boyfriend's virus. This is call 'super-infection', not meaning that the virus is 'super - powerful', but rather meaning that you, for example, could acquire his virus with the resistance mutation on top of (super) your own existing virus.

This is the reason that HIV doctors advise their patients with HIV to continue to follow safer sex recommendations - so that they don't spread the virus to someone else, AND so that they themselves don't acquire a second infection via 'super-infection'.

Even if you don't bleed, and he pulls out before he ejaculates, there is an exchange of seminal fluid between you, and infection can occur in either direction. The fact that you both have STDs makes a super-infection more likely.

So your response to ART could be compromised if you acquire his resistant virus.

For these reasons, I advise you to still practice safe sex and use condoms. And I advise you to take your concerns along with this email to your doctor and to you boyfriend's doctor and discuss these comments.


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