Positive/Positive Relationships

[kajnjewel]

I have been HIV+ for quite some time but I haven't dated anyone in years.  I am very much interested in someone that is also positive.  I have heard something about two postive people cross infecting or even becoming resistant to one another's meds if they had already built up a resistance (such as someone on AZT but one is resistant to AZT).  Can someone send me some links or information on two positive people that may some day become more than just casual.

Thanks

[kajnjewel]

Just wanted to say that I came across another topic and saw something about "superinfection" and was able to do a forum search and found all kinds of information on the topic.

Thanks for allowing me to post my question. 

[skeebo1969]

  My wife and I are both positive and we are on two different regimens.  So far we have not encountered the supposed "superinfection", nor have we encountered any resistance issues.  Other than a few very small blips on my part we have both remained undetectable, this after being together for 3 years now. 

  I know there are theorist and/or doctors that claim superinfections are real, but then there also seems to be another side that disproves or debunks these claims of risk.  My wife and I have decided to have as normal of a sex life as possible, meaning we don't use condoms. 

  Sorry if that was too much info, just my attempt at trying to convey my male point of view on the subject.

 

 

[kajnjewel]

Thanks so much Skeebo - your reply means a lot.  I have been only in pos/neg relationships since infection and have not been with anyone since 94.  I have met a great gentleman and he is poz as well.  I needed to hear what you said.  I am doing some research which is scary to say the least but it is great to hear from someone that has been there.

I do know that safe sex works in a pos/neg relationship but did hear about the reinfection terms back when.  Just now hearing the term "superinfection" for the first time. Guess that says how much I have stayed up on the topic since that term has been around since I last was with someone <he he>.  Not only am I worried about reinfection but med resistence.  How are your meds doing?

Thanks again.
Kajnjewel

[NLEWLAD]

hi,  can i just say  you the op  is looking fabulous

i am obvously also hiv poz

and also want a hiv positive boyfriend  (yes i am gay)  and i fullly support you in you finding a positive partner  = you will then relax and enjoy sex again and not worry


big hugs you you  and  greeting from the united kingdom  (53rd state of the USA  - I WISH)


XXXXXXXXXXXXXXXXXX

[kajnjewel]

Thanks so much for the compliment NLEWLAD <blushing on this end>  and for the good wishes.

Like you said - Anything is possible   

Kajnjewel

[skeebo1969]

  How are your meds doing?

  The meds are working fine for the both of us.  I am sure someone will eventually chime in about this whole superinfection thing.  I just wanted to add, HIV business to the side, be careful and use protection to keep from getting other std's.  There are some nasty ones that don't mingle to well with HIV.

  For example, I also have CMV.  According to my doctor it is not that big of an issue as long as my Cd4's stay above 200.  If they fall below blindness can occur he told me.  I am typing this with a little uncertainty mind you so I hope if I am mistaken someone will correct me.

[kajnjewel]

Thanks again Skeebo.  Will definitely take your advice especially since I, too, have a couple hiding as well just waiting for my T's to drop below 200.  I forgot about them until you mentioned it so THANKS, THANKS.  Didn't have to worry about them because I thought my intimacy days were over and done.  Just goes to show you that one should never say never again <grin> as I did after my divorce in 94.

Heck, it is like starting a brand new life all over again.  Really feels good to have some of those feelings to stir in order to get educated again in areas of HIV I forgot about

Thanks again.
Kajnjewel

[hotpuppy]

I think we all want a loving and affirming relationship with a wild sexlife. 

As for superinfection, I applaud you for doing your research.  I don't know very many (if any) gay men who are poz who practice safe sex with other poz guys.  As far as I can tell, it's always been this way.  I think if superinfection were real, there would be alot more of it.  That's just my observation and I'm not an expert.

I still treat people who are not drug compliant with distance and beware of other STDs.  HIV loves to have a party with it's friends.

[kajnjewel]

Thanks Hot Puppy for the applaud and your comments.  Means a lot.

[bill1322]

I don't know very many (if any) gay men who are poz who practice safe sex with other poz guys. 

I don't want to down play the good feelings this thread generated but I've been waiting for sometime for someone - maybe one of the administrators - to comment on this. No comments yet, so I will.

Is this really what Poz gay men do when they have sex with each other? (I'm hijacking the thread here.)

I've been Poz for 24 years and practiced safe-sex all that time. My ID doc warns me to not get re-infected or co-infected, but never talked about 'superinfection.' My primary care doc is a gay man and active in the HIV community altho not an ID doc. He warns me the same thing and does not have nice things to say about guys and 'barebacking.'

I've had various opportunities to have 'bareback' sex recently (amazing for someone my age) and always declined. Am I misinformed about what's acceptable behavior? Everything I've read on the 'net' about 'safe sex' is protecting those who are neg. There's hundreds of guys on the bareback website, many of them Poz, and they don't seem bothered by any of the safe sex rules. The site flaunts it.

Maybe I'm interpreting what Hotpuppy said too literally, but if I can go back to unprotected sex with other Poz guys, that would be great fun. I haven't lived this long to fuck it up (so to speak) on one wild and sloppy encounter.

Just how specific do you have to be in determining your partner's disease's compatibility with your own? Same meds? same VL? (I know an undetectable is less likely to transmit.) What else? What is acceptable? Specifics please! If I have to have the guy fill out a medical report before getting laid it might just be easier to put a condom on him!

Sorry about hijacking the original intent of this thread and making it so graphically gay male sex.

Bill














 

[red_Dragon888]

aka superinfection

http://www.gladstone.ucsf.edu/gladstone/site/pospart/

http://hivinsite.ucsf.edu/insite?page=ask-05-08-10

try search "superinfection positive partners hiv"

[kajnjewel]

Thanks for the articles Red Dragon - really appriacte them.

[hotpuppy]

I think this is a relevant question to the original post, Bill.

Short Answer: No, I don't think superinfection is something to be statistically concerned about.  I think that various HIV "authorities" have a hidden agenda to control sexual behavior and use superinfection and co-infection as "tools" to manage our beliefs about HIV and risk.

Long Answer, by point.
1) Observations.  Yes, gay men have lots of unprotected sex in many places ranging from hook up sites to bath houses, to bookstores, etc.  The sheer volume of poz to poz unprotected sex I am aware of indicates that superinfection is not happening.  If it was, we'd have alot of really sick guys out there.  We don't.  I don't know of more than one or two cases.

2) Technicalities.  Yes, you could in theory catch HIV 1 and HIV2.  Would it change your disease progression?  dunno... .probably not. You'd have to be screwing in Africa and the US to pull that off.  Not impossible, but difficult.

3) Co-infection with other STDs.  Yes, real issue.  However, once you have HIV and Herpes and are vaccinated against HepA/B there isn't much else out there...  Yes you can catch HPV.  I'm not aware of HepC as a STD.  I understand it to be more of a blood borne illness and specific to IV drug use.  Most adults have Herpes 1.  If you've had chickenpox, you have another herpes virus (same on that causes shingles). 

4) HIV subtype co-infection.  50/50 on this one.  According to http://www.avert.org/hivtypes.htm HIV-1 is what most of us have.  Group M contains most known variants.  Group N and O are restricted to Africa.  90% of infections are Group M. 
Quote:
Occasionally, two viruses of different subtypes can meet in the cell of an infected person and mix together their genetic material to create a new hybrid virus (a process similar to sexual reproduction, and sometimes called "viral sex").1 Many of these new strains do not survive for long, but those that infect more than one person are known as "circulating recombinant forms" or CRFs. For example, the CRF A/B is a mixture of subtypes A and B.

Subtype A and CRF A/G predominate in West and Central Africa, with subtype A possibly also causing much of the Russian epidemic.4

Historically, subtype B has been the most common subtype/CRF in Europe, the Americas, Japan and Australia. Although this remains the case, other subtypes are becoming more frequent and now account for at least 25% of new infections in Europe.

Subtype C is predominant in Southern and East Africa, India and Nepal. It has caused the world's worst HIV epidemics and is responsible for around half of all infections.

Subtype D is generally limited to East and Central Africa. CRF A/E is prevalent in South-East Asia, but originated in Central Africa. Subtype F has been found in Central Africa, South America and Eastern Europe. Subtype G and CRF A/G have been observed in West and East Africa and Central Europe.

Subtype H has only been found in Central Africa; J only in Central America; and K only in the Democratic Republic of Congo and Cameroon.


So in the US, you are likely to come across someone with Subtype B.

5) And your point caller?  Well, one more observation.  The same drugs work worldwide to treat HIV.  It's not like there is Atripla-B and Atripla-H.  No, there is Atripla.  Atripla works on HIV-1, period. 

6) Treatment factor.  This one is complicated.  There is a running theory that your Infectiousness Index (II) is related to your viral load.  i.e. someone with 100K/ml viral load is more infections than someone with <50/ml viral load.  This makes good basic sense.  Even someone with a viral load of 500/ml which would be considered "under control" is less infectious than someone with a higher viral load.

7) Treatment Factor Part 2.  Your treatment.  HIV drugs are pretty effective at screwing up HIV's party in your cells.  New drugs such as Selzentry and Vicriviroc are exceedingly effective at keeping HIV out.  For co-infection to take place the new strain would have to overcome all 3 drugs, get a foothold and multiply.  I'm not going to say it's impossible.... I'm just going to say it's statistically remote.

Immune Factor.  Your body has antibodies to HIV.  A new infection would be subject to an immune response.  It would be a foreign piece of matter, just like any other new infection.  Unlike your host virus, the new virus would be attacked.  So if you are on treatment and you have CD4s, the new virus would have it's work cut out for it.  The test for HIV looks for antibodies in your blood, just in case you are wondering.

So the aggregate here is this.  Yes, it is statistically possible, but very unlikely.  I think you have a higher risk of falling and hitting your head. 

The known cases tend to back this up.  16 cases in 33million.  so 1 in 2 million.  I'd suggest playing lotto first.  http://www.ncbi.nlm.nih.gov/pubmed/15995957 
http://en.wikipedia.org/wiki/HIV_Superinfection


Time is a factor.  According to this article, monkeys were infectable in the initial 4 weeks.  In 15 of the human cases the second strain appeared within 3 years.  However, keep in mind that our current testing models are like hunting for a grain of sand on the beach.  1 drop of blood in a body is a grain of sand on a beach.
http://www.medscape.com/viewarticle/504811


All of this reinforces my current beliefs.  I think that you have to be a bonafide cumslut/whore to get superinfected.  I'm not talking about screwing once or twice a week, or heck even 4 times a week.  I'm talking about going to the bathhouse, and getting screwed 50 or 75 times in a weekend and doing this for months and years. 

Let's do the math, shall we?

Case A, Monogamous HIV positive couples with same strain.  Exposure risk?  mirror.  Can you catch what you already have?  Would it matter?  Remember, viruses are genetic code with one mission, multiply.  Installing Microsoft Office on top of Microsoft Office still results in Microsoft Office. 

Case B, Sexually active person.  Engaging in sex 1 time per week, unprotected, with 52 partners per year.  Over a span of 10 years this is 520 exposures.  Risk, slight to moderate.

Case C, Very active.  Engages in sex 3 times per week, unprotected.  over 10 years this is 1560 exposures.  Sounds bad, but not really.  Moderate risk.

Case D, Super Active.  Engages in sex on average daily, unprotected, over 10 years we are talking 3650 exposures.  You really have to work to be at this level, but I know some guys who do.

Case E, Sex pig.  Engages in sex with 30 partners per week over 10 years.  14,400 partners.  Yes, you will have damn near one of everything.  This is someone who goes to the baths and gets screwed 30 times in a weekend.  I don't think there are that many guys in this category.

In conclusion, my belief is based on observation, reading, and simple analysis.  The analysis doesn't support superinfection as a high risk for my behavior.

Afterthought.  Testing in the past has not been terribly accurate or sensitive.  Only recently has genotyping really become widespread and sensitive.  In most of the data I've read the investigators had difficulty in isolating clear cases of superinfection.  This indicates to me that it's just not that common.  If it was common we would have lots of cases.  The behavior is there to support superinfection if it were a serious risk.

[hotpuppy]

One more tidbit.....

From: http://hivinsite.ucsf.edu/insite?page=ask-05-08-10

 One way to think about your risk is to imagine yourself several years in the future, with the benefit of knowing the results of research studies, and looking back on your behavior now. How will you feel if superinfection is found to be relatively common, and dangerous, and you were having unprotected sex? What if you were having protected sex? How will you feel about becoming superinfected, or superinfecting someone else? How will you feel about having had protected, or unprotected, sex if it is found out that superinfection is rare, or that the consequences are not very harmful?
//end quote//

This is guilt based manipulation.  Period.  It's important when reading articles to look for the authors intent and pick out the facts.  The answers in this article are amazingly concise, and then followed by guilt based behavior speak.

The answers in this article were:
Q: I am an HIV-positive 24-year-old female. I would like to know if it is safe for me to have unprotected sex with someone who also has HIV. My viral load is undetectable and my CD4 count is 107.
A:Thanks for writing.

Q:Am I at risk for being infected with my partner's strain of HIV, and am I at risk of infecting my partner with my strain of HIV?
A:Hard to say.

Q: Am I at risk for sexually transmitted diseases other than HIV?
A: Yes. Absolutely

Q: Does taking antiretroviral medicines and having an undetectable viral load reduce the risk of infecting a sex partner with HIV?
A: We all hope so, but no one knows yet.

So there you have it.... everything else is explanation or behavior modification.  I'm not pro safe sex or pro bareback.  I'm simply pro- informed decision.  There are times when I think it's appropriate to play safe, and times when I prefer not to.

My general rule of thumb is that if you are such a ho that I need to use a condom, I should probably not be having sex with you.  The reverse applies as well.  While condoms are very effective, they don't stop everything and they do contain some risk.  Just as walking out your front door has risk.  The key is to determine what level of risk you are okay with and what level you are not okay with.
 

[kajnjewel]

Since I made the original post and I have been reading everyone's post, I want to say thanks for all of the reponses.  I may have overlooked it in the posts but one of my concerns regarding two positive people being together (since condoms or NOT 100% and there is always a risk of somekind as far as additional STD's are concerned) is not so much being reinfected (superinfected) with a different strain BUT the question now is to whether or not they would become resistent to one another's meds should one have built up a resistance to most of the meds on the market where the other one has not.  (I have been positive for 19 years and resistant to most of the meds where my new partner has only been infected a few and is only resistant to one of the many on the market - my concern is whether or not I could cause him to become resistant to the ones I have become resistant to thus causing less options for him as well)

As I said, one of you may have mentioned it but could someone comment regarding this possiblity. 

[hotpuppy]

You could.... there really isn't enough research on this.  HIV is thought to revert back to wild type given enough time, but again I'm not an expert here......

I would say evaluate the risk and look at if you are on treatment that works and what resistances he or she has.  You can get resistance testing which will tell you an awful lot.

[kajnjewel]

Thanks so much for all of your responses which were all very informative Hotpuppy. 

[bill1322]

Thanks, Hotpuppy. I said be specific and you sure were!

I'd seen the HIVINSITE article before thanks to Red Dragon, and I agree - basically it's a fear based approach. "You can't go wrong if you do nothing." But your life might be pretty boring. And the experts just don't know.