HIV reinfection if Wife infected: Strain, Mutation, Condoms

Question

I have been infected by husband 2 years ago. He had no meds for 23 years, but developed AIDs defining illnesses 1.5 years ago and now on Truvada/Keletra about 75% adherance of time. My platelets went too low about 1 year ago, put on Reyetaz/Epzicom, 98% adherance. He also has Hep C, which should require Condom Use, but if he didn't have Hep C, just AIDS, could we rely on sharing the same strain, or would mutations by either of us put us at risk for super/re infection if he still refused to use condoms?

Answer

Thank you for your question.

Yes, you would be at risk of picking up a drug resistant virus if your husband did not use a condom during sex and his viral load was not suppressed by his treatment. Since his adherence to treatment is low, this would put you at risk. You should take whatever steps you can to protect yourself. Even if you started out with the same "strain", that virus has adapted to survive independently in each of you and on the medication you have taken.

Best, Joe