POZ Community Forums
Main Forums => Living With HIV => Topic started by: dizzy42 on June 24, 2009, 01:34:33 pm
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Hi to all and hope all are doing well,
I asked my doctor in present of my boyfriend if we have to use a condom since we are both HIV. She stated that because we both have the same virus, both taking atripla and both undetectable, we don't have to use a condom. However, she did also mention that because she is our doctor, she has to say we should use a condom but, if she was in our situation she wouldn't. She said if we both agree to be faithful and continue to take our medicine and both are undetectable, we don't have to use a condom. I'm confused? I know we should use a condom but, part of me don't want too especially if our doctor said we don’t have too. My boyfriend insists of using condoms and stated he doesn't want to have any problems with the virus. I feel that he is afraid of making things worst. Sex isn’t the same as far as touching, kissing and having oral sex. He has changed. He has with draw on many things we’ve done together after finding out about our status. However, I am the same person as I was before finding out about our status. I try to continue to do the things we’ve done before our status but, find it hard when he does not want too. I feel like he has with draw from me in a sexual way. I'm trying to live a normal life with him but, I feel he has changed with me. Don't know what I'm feeling now. I love him dearly and I know he loves me too. He always checks up on me, making sure I am taking my med's, vitamins and that I'm eating and resting. I just feel like he might be seeing me as a big disease. Is this normal for couples living with HIV? Or is this just me? Need some advise please.
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Maybe it's just due to low testosterone, which is fairly common with HIV. So both of you (especially him) should make sure your testosterone levels are normal.
I'm not sure what your question is, are you asking if what your doctor said is accurate about not having to use a condom or are you asking for advice about the fact that your partner is withdrawn?
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I think I do understand why he is doing this. I think and hope is that he doesn't want to make things worst. If giving him his space will help him on what he is feeling, then I will do that. I will not try and would not want him to feel guilty in any way. We both agree that we will stay faithful. Having sex is present, it's just I'm missing the other things we use to do. He is very caring and that is why I love him. It's just I'm starting to feel undesirable to him. I just assumed that you can still live normal sex lives together living with HIV. I'm new to this and I know it's going to take some time, but I just wanted some feed back so, I can understand this new path.
Thank you
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My questions is both and what ever advise you can give. Is it true on what our doctor is saying?
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I think your doctor is basically correct that if you are both poz and undetectable and you are on the same regimen it should be OK not to use a condom. I happen to be very conservative when it comes to these things and I personally would still insist on a condom but I know that many others don't feel the same way. Remember, you would both have to be 100% faithful for that to work or if you did have sex with others, you would always have to use a condom outside the relationship. There are other STDs out there, nasty ones, that are further complicated if a person has HIV.
There are many relationships with both partners poz and they have a great sex life. This is all very new to both of you and sometimes it takes time to get adjusted to this new life.
I do think more important than the sex is that you both are loving and affectionate and caring toward each other. And both should get your testosterone checked!
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(I do think more important than the sex is that you both are loving and affectionate and caring toward each other.)
Yes, I agree, thank you.
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Maybe it's just due to low testosterone, which is fairly common with HIV. So both of you (especially him) should make sure your testosterone levels are normal.
Actually I'd go with post-diagnosis situational depression as my first guess. If it was due to low testosterone he'd probably have had a low sex drive before the actual diagnosis.
I'd encourage the OP to get his partner to have one-on-one therapy, or even to do couples therapy, or both.
Otherwise in respect to the condoms the doctor's views are entirely correct.
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His sex drive was high before the actual diagnosis and believe and hope that maybe it will soon get to the way it was. I think it's just dealing with the virus that is making him think twice about letting go.
(Otherwise in respect to the condoms the doctor's views are entirely correct.) wow, I didn't know that was possible, but I will respect him if he still wants to use a condom.
thanks
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Hubby and I don't use condoms, are both on Atripla and undetectable, and have some differences in terms of resistance. In fact, I've not met any guys that are HIV+ who use condoms at all except with negative guys.
As for him not wanting to have sex, I think I'm going to agree with our resident sexpert Miss Philicia's comments about situational depression. Personally, I didn't suffer from that, but I did benefit from some counseling dealing with disclosing to my family.
David
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dizzy,
As long as you two are not picking up other STIs outside your relationship, there's no real reason to use condoms. My partner and I are both poz and we have never once used a condom - not with each other anyway.
And by the way, I'm a little confused. Are you both men? I'm wondering because you also posted this in the Women's forum, but there's no indication one way or the other (man/man or man/woman) in your posting history.
Ann
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Hello
Ok the science...
The concern is acquiring a 2nd lot of HIV and/or a resistant kind of HIV.
If you do indeed have the same virus, you can't cos there's only the same virus involved.
If you both take your meds and remain undetectable, then you can't give each other resistant HIV, because there will be none to give. The no other STIs + taking meds consistently bits are an important combination here.
Now the head bit...
I think your partner has not got to grips with his HIV diagnosis, and somehow sees it as a negative judgement. Condoms = being a good boy.
- matt
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I think it's just dealing with the virus that is making him think twice about letting go.
OK, so why not consider counseling?
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Ok, I responded when you posted this in the Women's thread. But I see our condom goddess has given you some good advice along with the others who chimed in. I wish you luck with your bf, in time he may change his ways....
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Thank you all,
I'm female and my hubby is a male. Your replies have been great. Don't know how long it will take for him to open up but i will be there for him. Also, just wanted to let you all know that reading your replies has put me in peace knowing that it's not me. I shouldn't feel that he's losing interest in me. As it is, my self esteem isn't that high and after feeling a little rejected by him has put me below a little. I will keep my head up and support him in every way. Just have to learn and listen. thanks
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I do think more important than the sex is that you both are loving and affectionate and caring toward each other. And both should get your testosterone checked!
LOL I didn't realize you were female, "ixnay" on the advice for you to get your testosterone checked!
While I do agree with Miss P that your partner's reticence with sex is more psychological due to the recent diagnosis etc., it's always a good idea for any male who has HIV to know what's going on with his testosterone levels since it's common to have low levels if one is an HIV+ male. If by any chance the level is low, it's fairly easy to do some sort of hormone replacement, either with Androgel or a shot, etc.
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??? ??? ??? Hmmm... ??? ??? ???
I'm not sure if I should start a new thread to post these questions prompted by dizzy's original post and the follow-up responses or if it's OK to post here since my at least one of my questions is directly applicable and the other not so much. So, sorry in advance if I've committed a no-no.
Dizzy, how does your doctor KNOW (for a fact) that you and your boyfriend have the "same virus"? I mean, duh, you both are HIV+, but did you have identical resistance patterns on the resistance testing done prior to initiating therapy? Were there additional viral genotype tests done to determine that you do indeed have "the same virus"? Or were certain assumptions made regarding the timing of yours and your boyfriend's initial HIV diagnoses (i.e. he MUST have given it to you or you MUST have given it to him)? Just something I'm not clear on and am curious about and don't intend to be unduly nosy.
So, this is the question that maybe should be posted to a separate thread: I keep hearing people say or write (here and in other places) that if you're "undetectable" you're basically NOT infectious to a partner sexually. Assuming for a second that that's true, by "undetectable" do you mean <50 copies/ml or <40 copies/ml or <48 copies/ml or <400 copies/ml (which is what was considered "undetectable" a few years ago with an older test)? "Undetectable" virus in the plasma is NOT "zero virus in the plasma" and "undetectable" virus in the plasma does not necessarily mean "zero virus" in the semen. And since it's fairly common for those who have had undetectable VLs for a while to have random blips of detectable virus (which may be real and not due to lab issues), how do you know, on any given day that you're "still" undetectable? It just seems to me that in certain circles/situations (and NOT all by stretch of the imagination), "I'm undetectable" has become the new "I'm HIV-negative. Just tested 2 weeks ago." or "I won't cum inside you." little white lie told by some to get what they want sexually.
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My hubby gave it to me. The condom broke and we continued to use a condom until a few weeks after we decided not too. I've told him I test every year and I'm negative. He said his job test him every year and never had a problem. When I questioned him if he every had to sign a release form to be tested he said no. So, that made me think and I decided to tested myself to be safe and the results came back negative (Sept 2008). The condom broke in June so, I tested again in Sept. In December 2008 I started to get sick, rash, lymph nodes swollen, fever, etc. Doctor could not find out why I was getting sick so, In March 2009 he tested me for HIV and that is when the results came back positive. He said when I tested in Sept. I was in the window period. I've tested negative in Oct 2007 and negative in 2006. Was not in a relationship since Oct 2006 until I met my hubby. That is how I know my hubby gave it to me. So, when we went to a HIV clinic together and was tested, she stated that we both have the same virus. She also, mentioned that our VL were the same 13500 and my CD4 was 239 and his was 233. We tested last month and both results came back undetectable (under 50). That is when I asked about the condoms. I'm learning about the virus, so all this is still new too me. But from what she said, we have the same virus.
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I agree, seems like you could benefit from couples therapy, or your partner from individual therapy. Keep in mind life changes constantly, and you can't necessarily "recreate" some past sexual exchange - your future sex life might evolve somewhere unknown, cause you BF has the right to his changing feelings about his body and sex....
Modified - what i mean to say is that I picked up on the feeling that he is holding back or withholding, though you don't go into details.
My therapists says withholding in sex is not usually the basic issue - its a symptom. Sex problems are a mutual responsibility. It could be something about he feelings about HIV or maybe completely tangential. Communication between you two. Or not. Etc.
I think couples need impartial professional help to deal with such a challenge.
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In fact, I've not met any guys that are HIV+ who use condoms at all except with negative guys.
That pretty much mirrors my observations. From what I can see it's been this way for a long time. So if superinfection was a real issue I think we'd have a lot of sick poz guys.
The CDC numbers I was able to find had a few documented cases where the individuals were hyper-exposed to unprotected sex. By Hyper exposed I mean they went to the baths 4 or 5 nights a week and had sex with 20 to 30 guys a night for years on end. The shear mathematics suggest you are in trouble with that sort of risk exposure.
On the other hand, most poz guys have 2 or 3 partners per month, maybe 6 on a good month. That equates to 72 partners a year, let's just call it 100. That's 1/52nd of the exposure documented by the CDC on the super-infection cases. All of which is moot if it's you, but it seems like you have a better chance of getting food poisoning, seeing as you eat, on average 1000 times per year and like STD's it only takes one exposure to make you sick.
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On the other hand, most poz guys have 2 or 3 partners per month, maybe 6 on a good month. That equates to 72 partners a year, let's just call it 100.
wut
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maybe 6 on a good month
erm, like Miss P said, wut?
6 maybe in a good year, then again, maybe jus 1 good man/woman.
sure, there are people who shag around lilke bunnies, but this is not unique to HIV-positive people
(sorry to go a bit off-topic)
- matt
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On the other hand, most poz guys have 2 or 3 partners per month, maybe 6 on a good month.
Where are you getting your stats?
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6 partners in a months time? I don't care if you're gay or straight but to me that person is being mighty whorish. And would or should be concerned about picking up something else. Now I was told by my doc that it is NOT good to have sex with another pozzie without a condom regardless if you're undetectable because of something about building a resistance to the meds the other is taking. Is this true or not? From what I am reading here, it doesn't seem to be.
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Now I was told by my doc that it is NOT good to have sex with another pozzie without a condom regardless if you're undetectable because of something about building a resistance to the meds the other is taking. Is this true or not? From what I am reading here, it doesn't seem to be.
No, it's not true. The problem is if the person is resistant to any of the meds and if they're NOT undetectable, there is a small chance of them re-infecting you with their resistant form of the virus. The danger is from their virus, not from their meds. While this has happened, it is VERY rare and it seems it has only happened when the person being re-infected had a very new infection to begin with.
My bf and I never use condoms. He's on meds, has no resistance issues and is undetectable, and I'm NOT on meds and also have no resistance issues. We can't reinfect each other and we have the same virus anyway - he's the person from whom I acquired my virus in the first place.
Ann
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We can't reinfect each other and we have the same virus anyway - he's the person from whom I acquired my virus in the first place.
Ann
Ann
I don't think you can really depend on the idea that just because you were infected with the virus by someone years ago, you still have the same virus as him today. HIV is not stagnant inside a person. The whole point of superinfection is the risk of picking up a virus that has evolved to be resistant to a drug. So if your partner's virus had evolved to become resistant to drugs since infecting you, the two of you would no longer have the same virus and it is conceivable that you could become infected with a new resistant virus strain. The important point is that he still has no resistance and so cannot give you any.
That said, superinfection risks do appear to be pretty rare and concentrated among those recently infected.
Dizzy
As long as you are only having sex with one person, the only way you can get a "worse" case of HIV is if that person does, either by not being good about taking his medicines and having his virus evolve to become resistant or by getting reinfected by somebody else. The risk in either case is pretty rare, even for someone, like you, who is newly infected.
Assurbanipal
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Erm, I am with Ann on this
1. Fully suppressed virus does not develop mutations leading to resistance (because it's not replicating)
2. Untreated virus does not develop mutations leading to resistance (because there is no drug to create the environmental pressure needed for this to happen).
This is kinda beside the point for the OP. The question seems more one of happiness with self and others.
- matt
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Jebus, how many times have we done this issue? Can't we make a "Best of" stickie somewhere?
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You guys are great. The information you guys are giving are taken seriously. I spoke to him last night about a little of what is going on with the virus and us. He seems to still worry and assured me that it's just going to be me. He said we're in this together and will fight this together. However, he still wants to use a condom and I can respect that. We both are still learning and is still a shock to the both of us. He worries a lot about this. He worries a lot about me getting sick again. I got so sick in December, passing out more than once, lost 10 pounds fast, fevers, colds, asthma, low blood pressure, doctor found out I have a clogged vein in my right side of the heart that beats slower then the left side, was weak all the time and not eating. Our HIV doctor told me it's a good thing that I tested at the early stage because my immune system was weak. She stated I could have gottan AIDS very quickly. So, I guess that is why my hubby is concern about using a condom. He's afraid of making things worst. He is always checking up on me and also, taking care of himself. He's working out, eating more (healthy food) and resting more. We stop going out at night (dancing, bars, drinking). We're in bed by 10pm - 11pm. We take our med's the same time. Life is different right now but still living it.
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dizzy42: it sounds like you guys are doing the right thing...I'm curious, what meds are you on and what meds is he on?
Queen Tokelove: In your signature line it says you were off meds for 2 months, when you went back were you able to go on the same meds (no resistance had developed)?
Thanks ;)
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Queen Tokelove: In your signature line it says you were off meds for 2 months, when you went back were you able to go on the same meds (no resistance had developed)?
Yes, I am on the same meds. I am concerned because my numbers seem to keep bouncing if you noticed that in the sig line. And my percentage went up from 23-24 percent. But I was wondering if my drop was because I was having sex with my bf w/o a condom, thus the re-infection question which seems to have unnerved Miss P because it was mentioned before. But I don't have the patience to go scrolling back for it. And the OP being new did not know about the previous threads about re-infection. So people should remember that when commenting about how many times it has been talked about and maybe be nice and post the previous thread about it. Just saying and excuse me if I am coming across as bitchy.
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Dizzy,
You're bf is only going to make you sick by having unprotected intercourse with him if he has another sexually transmitted infection. He's not going to give you hiv again. There are some members of this forum who are ultra-cautious on this point, but I'm not telling you anything I don't believe and practice in my own life.
However, if sex with a condom is what makes him happy at this point in time, then go with the flow. It's very early days for you guys and he'll become more comfortable in time. Unless you're one of those people who has a sensitivity to latex or otherwise hates condoms, there's really no reason to push the issue - for now, anyway.
And the thing about him not going down on you anymore is kinda silly, if you don't mind me saying that. Saliva is NOT infectious, and not only that, but going down on an hiv positive woman isn't a risk for him either, even if he were still hiv negative. Tell him to wise up and get himself down there. ;)
And you know, I have to question your hiv doc. You were tested during the acute stage of your infection, a fact shown by your previous testing history. You said in your first post here that "She [your hiv doc] said it was strange that my CD4 was low considering that I've test negative on 9/30/08 and in Oct, 2007". In the first year or so of infection, it's not unusual to have numbers like what yours were. Not unusual at all. If you had been given the chance to have more blood draws before being put on Atripla, you might have found that you didn't need the meds so soon. You'll never know now. A responsible doctor will not put a patient on meds right away with numbers like what yours were and given the newness of your infection - they'd wait a few months and see what sort of trend you had going on. Sorry to be the bearer of news like that, but it's true.
Hang in there hun, it's gonna be ok, one way or the other.
Hugs,
Ann
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We are both on atripla. My hiv doctor told me she wanted me to start right away so, I did. I was scared not too. Yes, I'm sensitive to latex condoms. Using non-latex lubricated condoms from lifestyles (skyn). It seems to do the job.
(Tell him to wise up and get himself down there). lol I will mentioned it :)
thank U :)
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Queen Takelove: I guess there was no resistance test done when your VL went up to 18k after being off meds for 2 months?
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A responsible doctor will not put a patient on meds right away with numbers like what yours were and given the newness of your infection - they'd wait a few months and see what sort of trend you had going on. Sorry to be the bearer of news like that, but it's true.
There are studies ongoing looking at the benefits of starting early (within the first year of infection). It's been shown that doing so results in significantly smaller reservoirs, which may (or may not) be a benefit to overall health as well as to possible eradication later on.
It's too soon to tell if there are benefits to starting that early of course but my point is that starting very early even with good numbers is something that should not necessarily be dismissed. Back in the day when the meds were so much more toxic it was more of a concern.
The biggest unanswered question when it comes to HIV treatment is: when is the optimal time to start HAART? At the end of the day, it's all one big balancing act.
Individuals who have started treatment early in infection carry a viral reservoir of limited size that is harbored mainly by TCM cells,
LINK:
http://www.natap.org/2009/ResisWksp/ResisWksp_43.htm
EDITED TO ADD:
Another possible advantage to starting very early with good numbers is that there is a chance of later on being able to go on treatment interruptions without the usual dangers involved.
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Queen Takelove: I guess there was no resistance test done when your VL went up to 18k after being off meds for 2 months?
I believe there was because of me being on Ziagen but don't hold me to it. I know he did some type of test to see if I had an allergic reaction to it. I guess that can happen with Ziagen. Though I have been infected for quite some time, I still don't understand half the things they make me do.
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Another possible advantage to starting very early with good numbers is that there is a chance of later on being able to go on treatment interruptions without the usual dangers involved.
Just want to clarify: based on current studies the above only applies to those who start extremely early, meaning within the first few weeks of exposure.