Two different regimens, how does that work?

[Falkore]

Hey guys, I've been away from here for a long time and I've missed you all. Things are going well for me, but I had a question.

I have a friend who just a year ago found out he was HIV+. He got sick with PCP and was hospitalized for a few weeks. He's now on meds and doing well. He finally got his VL to undetectable and his CD4 is around 300. The question I have is this: Assuming we got into a committed, monogamous relationship, is there a problem with us having unprotected sex if we are on different meds? I'm on Atripla and have been undetectable for 5+ years. He is on Norvir, Prezista, & Truvada. Is there a possibility of problems? I know there is a risk of resistance to the meds, but I just thought I'd put this out there for the more educated to give their 2 cents.

What do you guys think?

[kellybryana]

Don't take a chance. Use a condom.

Just my advice. I feel like I learned my lesson getting HIV in the first place. I don't think I will have sex without a condom ever again. My health is too important to me to take another chance.

[newt]

To be realistic, if your adherence is good and viral load stays undetectable, and importantly both have no other STIs, practically speaking, no there ain't a problem. Especially if you have the same/similar types of HIV and no pre-treatment resistance.

There is 1 case report of two guys on meds where a resistant virus was transmitted, but one of them did not have a suppressed viral load and was not taking his meds consistently. Which demonstrates the point above about undetectable/adherence...

Meanwhile, 100s probably 1000s of people in your situation have unsheathed intimacy every week without problems....

Perspective on risk, especially very small or theoretical ones, complex topic often varnished with fear. Different people will make different decisions here. Either way is a fair call for persons concerned. But I personally worry more about crashing in a car of a day or falling down some steps, the risk to life and limb is greater.

- matt

[jkinatl2]

To be realistic, if your adherence is good and viral load stays undetectable, and importantly both have no other STIs, practically speaking, no there ain't a problem. Especially if you have the same/similar types of HIV and no pre-treatment resistance.

There is 1 case report of two guys on meds where a resistant virus was transmitted, but one of them did not have a suppressed viral load and was not taking his meds consistently. Which demonstrates the point above about undetectable/adherence...

Meanwhile, 100s probably 1000s of people in your situation have unsheathed intimacy every week without problems....

Perspective on risk, especially very small or theoretical ones, complex topic often varnished with fear. Different people will make different decisions here. Either way is a fair call for persons concerned. But I personally worry more about crashing in a car of a day or falling down some steps, the risk to life and limb is greater.

- matt

This. And I suspect that many folks who have had long-term experience with HIV will concur, I have yet to encounter a Re-/Super-Infection in my 18 years being positive.

[Ann]

My positive partner and I never use condoms (with each other) and it's never, ever been a problem - aside from when I acquired my hiv from him in the first place. As Matt said, unless other STIs are involved, there shouldn't be a problem so don't listen to the scaremongers who insist on condom use between two pozzies.

[bocker3]

My positive partner and I never use condoms (with each other) and it's never, ever been a problem - aside from when I acquired my hiv from him in the first place. As Matt said, unless other STIs are involved, there shouldn't be a problem so don't listen to the scaremongers who insist on condom use between two pozzies.

While I agree that the "fear" of re-infection is not supported by the evidence, I don't think it is "scaremongering" to have a different idea about condom use between positive partners. 
Everyone makes their choices based on what they feel is right for them.  Perhaps some simply do not want to risk even the possibility of acquiring another STI.  After all, a very wise woman has been known to say, "Having unprotected vaginal or anal intercourse, is agreeing to the risk of acquiring an STI." (or something similar).

Mike

[Ann]

While I agree that the "fear" of re-infection is not supported by the evidence, I don't think it is "scaremongering" to have a different idea about condom use between positive partners. 
Everyone makes their choices based on what they feel is right for them.  Perhaps some simply do not want to risk even the possibility of acquiring another STI.  After all, a very wise woman has been known to say, "Having unprotected vaginal or anal intercourse, is agreeing to the risk of acquiring an STI." (or something similar).

Mike

True, but I did say "unless other STIs are involved". I was primarily talking about people who are securely monogamous and/or are regularly tested for other STIs - and you know them well enough to know they are regularly tested. I'm not talking about BB with other pozzies who are virtual strangers, I'm talking relationships. Sorry if I wasn't clear.

[Falkore]

Hey guys,

Thanks to everyone who responded. I was pretty much on the same page as most of the replies. My friend has not been with anyone since testing poz. He's been under a Dr's care and has had multiple tests to make sure he is healthy. If we decide to have sex bare, I know that I would be taking a risk of contracting another STI, but I was more worried about the possibility of "super infection". I had thought it was a low chance, but I wanted a wider opinion. Looks like me and my friend might just decide to have a little fun after all.

Thanks again.

[jkinatl2]

Super infection is a boogeyman used to scare us pozzies into being afraid, still, of sex.

Syphilis is another story, but oddly you rarely hear of THAT.

[Ann]

Super infection is a boogeyman used to scare us pozzies into being afraid, still, of sex.

That is EXACTLY how I feel about it. It's just a big, bad, IMAGINARY monster that some would like to have you think lives in your closet. It's just a way of keeping you in bed at night - ie, keeping you "in line".

Lots of health care providers - hiv NEGATIVE  health care providers - don't like to think of us pozzies having a sex life. Fuck them. Seriously. FUCK. THEM.

[newt]

I just spent a weekend doing what the OP thinking about (or his mate) it was uncomplicated, normal and a damn good weekend of which the knobbing was a small part. Go for it. Life is now. << this said, have seen me mate's genotype, know his treatment history etc, it's not quite a casual/tonight thing :-)

- matt

[Since2005]

Super infection is a boogeyman used to scare us pozzies into being afraid, still, of sex.

LOL.. I think Ann told me about that Boogyman not too long. The superinfection thread comes to this forum almost everyweek and I been hearing the same answers almost all the time and yes that Boogyman too