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Is It Safe For An HIV-Positive Person To Have Unprotected Sex With Another HIV-Positive Person?

When both partners in a sexual relationship are HIV-positive, they are called HIV seroconcordant sex partners. Having anal or vaginal intercourse with an HIV-infected person when you're HIV-positive yourself is a good strategy to lower HIV transmission. However, seroconcordant sex partners are still at risk of acquiring other STDs through unprotected sex. Moreover, there is always a strong possibility of reinfection or superinfection in such partners. 


RISKS OF UNPROTECTED SEX IN HIV SEROCONCORDANT SEX PARTNERS

Previously, seeking HIV-positive partners was a documented strategy for HIV transmission risk reduction in HIV-positive people. Unprotected sex between two partners who already have HIV seems harmless. However, it is not without its fair share of risks.


Unprotected sex between two HIV seroconcordant partners carries the risk of what's called reinfection, or a superinfection. Studies have shown that HIV-positive people can still be re-infected with other genetic variants of the virus from their HIV-positive partners. The newly acquired variant of the virus might be resistant to that person's medication and may cause a flare of symptoms in an otherwise controlled environment.


Reinfection with a different HIV variant may lead to genetic recombination of these viruses, resulting in what's known as superinfection. HIV superinfections are very difficult to treat and manage. In addition, these infections can be resistant to multiple (or all) drugs included in ART therapy. Although the prevalence of superinfection among HIV seroconcordant partners is low (around 4%), the consequences of such infections are harsh. Many people in such situations experience extreme symptoms. Therefore, protective measures should be undertaken for the prevention of superinfections.


Another risk that unprotected sex among HIV seroconcordant partners carries is the transmission of other STDs. Having HIV makes you more prone to acquiring other STDs, which is why so many HIV-positive people in the U.S. have concurrent STDs as well. These sexually transmitted infections can complicate the course of your HIV and even limit your treatment options.


LOWERING THESE HEALTH RISKS

Taking protective sexual measures is important even when both partners have a positive HIV status. This is due to the complications that arise with superinfections and the transmission of other STDs. Simple protective measures go a long way in making the course of your HIV much smoother. Here are some of the measures that you and your partner can take to protect yourself from such complications:

  • Using condoms for anal, vaginal, or oral sex
  • Using a new condom for every new sexual encounter
  • Taking anti-retroviral therapy regularly
  • Ensuring that your partner takes their medication regularly as well


Sometimes, it can be challenging to introduce condoms into your sex life if you have unprotected sex with your partner for a long time. Talking to your partner about the associated health risks is crucial in such situations. Talking to a healthcare physician or even a sex therapist may help convince your partner of the health and sexual benefits of using a condom.


Another important aspect to keep in mind is to keep your doctor updated about your sexual practices. For example, if you practice unprotected sex with your HIV seroconcordant partner, your doctor might want to know this information when formulating your medical plan of care. They might also need to know this information in case a serious complication arises.


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