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Unprotected Sex between treatment naive and experienced HIV+ Men.
May 9, 2009

My boyfriend and I are in a monogamous relationship. I am HIV treatment naive and I am a bottom. My boyfriend is a top and he is treatment experienced. Recently, we have been having anal sex without protection. He has undetectable viral load for a year and a half now. He still takes his meds. He does not cum inside me. I want to know. How high is the risk for superinfection regarding our status.

Response from Dr. Frascino

Hi,

Unfortunately there are no reliable statistics pertaining to degree of risk for your exact situation. What I can tell you is that superinfection is indeed real and you are indeed putting yourselves at risk by having unprotected sex. We know HIV superinfection occurs and have scientifically documented the phenomenon, but we don't know how often, as it's difficult to diagnose and confirm. (The laboratory tests are complex and costly.) It seems to occur more readily in the early stages of the illness. That your top-gun boyfriend has an undetectable HIV plasma viral load on combination antiretrovirals will decrease, but not completely eliminate, the risk of HIV transmission. I would suggest both you and your Mr. Right read through the information in the archives of this forum related to superinfection/dual infection risk. I would also strongly recommend you begin using latex condoms for all penetrative sex.

Good luck to you both.

Dr. Bob



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