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BF on anti hiv drugs I am not

Nov 19, 2009

Hello Dr Frascino and I hope youand your partner are doing well :) My partner is on Atripla and has been for a year, I am positive too but not on any medication. My question concerns sex. I am the top in our relationship, and I would like to know, if me and my boyfriend have unprotected bum fun, is their a risk of me having resistance issues to any of the components in atripla? I have had a test and the HIV I have is susceptible to all anti HIV medicine. My boyfriends VL is undetectable and mine is low 6790 last time it was tested. We are monogamous and dont play away.Is it best to wait until I am on medication too if we both want to consent to unprotected sex? We just crave for the level of intimacy we had before we found out about being positive. In fact our sex life is only just returning after a year, its been hell. Any answer you can give would be appreciated. many many thanks. I appreciate you do not condone unsafe sex, but we have been together for years and as I said we are monogamous. uk lad

Response from Dr. Frascino

Hello UK Lad,

You ask if there is a risk of a superinfection whereby you could contract another strain of HIV that is resistant to one or more components of Atripla. The answer is yes, there is at least a theoretical risk this could happen. In order for this to occur, however, your partner would first have to develop resistance to one or more components of the Atripla he is currently taking. Then you would need to acquire his strain of resistant virus via unsafe sex. How likely this scenario is to occur is difficult to predict. We know that the risk of HIV transmission is significantly decreased if the HIV viral load is suppressed to undetectable levels by combination antiretrovirals.

You're correct: I certainly would not recommend unsafe sex between two HIV-positive folks for a variety of reasons. Only you and your partner can decide what level of risk you are both willing to accept. I, for one, would not risk it!

Good luck to you both.

Dr. Bob

Case numbers for rare subtypes (TESTING FOR SUB-TYPE O)
Thank you kindly for replying Doc

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