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I'd Like To Know The Facts
Mar 28, 2010

Hi there Dr. Frascino, I have a question for you.

I am 21 and have only had unprotected sex with one partner, my current boyfriend/fiance and we have been together for over a year. We however just learned that we are HIV+. Clearly the situation has been devestating for both of us but with a good family support system and each other we will both be fine, Im sure of it :) Clearly we have established that my boyfriend is the one who unintentionally gave me the virus but thats really irregardless to me, dwelling on "who infected who" seems pointless to me and we need to focus on our future. I understand the "possibility" of super infection between partners and I'm aware of the risks. Ive read a few scientific journals and studies on different AIDS sites saying "unprotected sex between longterm partners shows little or no risk of superinfection". My partner and I have has unprotected sex AT LEAST 300+ times throughout our relationship, clearly both of us being positive at the same time and not knowing of our status. We are to be starting the same medication and I know that unprotected sex is still "unrecommended" but I wanted to know if there are any FACTS or PURE RESULTS showing the actual percentage or chance of superinfection. Is it pretty much our risk to take if we choose to do so? Like I said, we are 21 so I highly doubt for the next 50 years we will ALWAYS be using condoms, however we will ALWAYS be monogamous. I would just like for someone to explain to me the ACTUAL facts or the "howevers" of the situation as opposed to placing the big BAN and NO-NO sign on it because frankly it's not that realistic for such a young and monogamous couple. I appreciate your advice and input to our situation. Thank you so much

Response from Dr. Frascino

Hi,

I'll respond only briefly, as I've addressed this topic numerous times over the years and you can review those extended comments in the archives of this forum.

The facts simply stated are:

Superinfection can occur. Exactly how often it occurs is difficult to document, because of the intensive laboratory analysis required to formally document the process. It appears superinfection (dual infection) occurs more readily early in the course of the illness.

Even though you and your fiance may have the same strain of virus and may be starting the same medication, HIV evolves differently in each person. Consequently superinfection could still occur.

Effective combination antiretroviral therapy that drives the HIV plasma viral load to undetectable levels for a significant period of time significantly decreases the risk of HIV transmission.

Only you and your fiance can decide what level of risk you are willing to accept. The current strong recommendation is that you use latex condoms for all penetrative sex.

Good luck.

Dr. Bob



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