Pozitively Healthy: A Gay Man's Guide to Sex and Health in Canada

Positives Attract ... Sex Between HIV Positive Guys

Some HIV positive guys decide to only have sex with other HIV positive guys. For a lot of us this is a way to prevent HIV transmission and to enjoy sex without condoms. Here are some things to think about before getting it on with the condom off.

How Do You Know His HIV Status?

How do you know each other's HIV status? Sometimes we assume or guess about a guy's HIV status. There could be serious consequences if we guess wrong. Unless you talk about it with him, you probably won't know for sure whether he is HIV positive.

Your Risk of HIV Re-Infection

Once you have been infected with HIV, you no longer risk becoming HIV positive. But you might be "re-infected" with HIV. Re-infection happens when a person gets infected with a different type (also known as a "strain") of HIV on top of the type the person already has. Re-infection is sometimes called super-infection.

Re-infection is hard to study. Nobody really knows how often re-infection happens. Only a few dozen cases in the entire world have been identified with total certainty. But re-infection may be more common than that. We just don't know.

What does re-infection mean for your health? We don't know for sure. We do know that there are different strains of HIV. Some strains of HIV are more powerful than others. We also know that HIV can become resistant to certain HIV medications. Suppose that a guy has a stronger strain of HIV. And his HIV is resistant to HIV medications that your HIV is not resistant to. You might get sicker faster if you are re-infected with his HIV.

Do You Have a Legal Duty to Disclose Your HIV Status to a Positive Guy?

Even if you know that the other guy is HIV positive, you might have a legal duty to tell him that you are HIV positive before having sex. Based on what we know about the criminal law, you might have a legal duty to tell him your HIV status if:

• There is a significant risk that he will become re-infected with HIV; and
• Re-infection will cause him serious bodily harm. But there is not a lot of scientific evidence about the risk of re-infection, or whether re-infection can cause serious harm.

As far as we know, no one in Canada has been criminally charged for not disclosing his HIV status to another HIV positive person.

For more information about HIV disclosure, sex and the law, read HIV disclosure: a legal guide for gay men in Canada.

Sex, Drugs and Recreation

Some guys use party drugs when they have sex -- or have sex when they are using party drugs. Other guys have strong negative views about party drugs and won't go anywhere near them. Party drugs are sometimes called "recreational" drugs.

Party drugs can affect your health, especially if you take party drugs often or take large doses of them. Party drugs can change the effect of HIV medications. And HIV medications can change the way your body reacts to party drugs. Here are some things to be aware of:

• Protease inhibitors (a type of HIV medication) can really increase the concentration of party drugs in your body. This means that the same amount of party drugs can have a much bigger effect on you.
• Drinking alcohol can increase the level of the HIV medication abacavir (Ziagen) in your body.
• If you are taking ddI (Videx), drinking alcohol increases your risk of developing a dangerous swelling of your pancreas.

If you are not sure what HIV medications you are taking, check with your doctor or pharmacist. Your pharmacist should be able to answer questions about how your HIV medications react with other medications and party drugs.

You can get more information about HIV, HIV medications, party drugs and your health from CATIE (Canadian AIDS Treatment Information Exchange). Call 1-800-263-1638 [if you're in Canada] or visit www.catie.ca.