Unprotected Sex Between HIV+ Partners: Harmful?

Unprotected Sex Between HIV+ Partners: Harmful?

Another concern that frequently arises during our discussions on the risks of unsafe sex between HIV-infected partners is the possibility of acquiring another strain of HIV, in particular one that might be more aggressive (virulent) or perhaps one that is resistant to antiretroviral drugs. While this possibility often is the greatest worry among the patients, we unfortunately have limited information regarding the actual risk.

I always inform my HIV patients that we are on firm ground regarding our understanding of the risks of acquiring the traditional STDs, hepatitis B, HPV, and probably hepatitis C. The data are less clear for HHV-8 and regarding the possibility of HIV super-infection (infection by another strain of HIV on top of the one the person already has). It is worth noting that there have been increasing reports of cases of suspected superinfection. Although the data remains limited it suggests that when superinfection occurs it may be associated with CD4 decline and possible disease progression. Based upon this emerging data I believe it is important for people to be aware of this potential risk while this area of research continues to evolve.

In summary, individuals need to know the currently available facts regarding the risks of unsafe sex between HIV-infected partners. If they choose to assume the known and potential risks, they should be screened for the sexually transmitted diseases and treated when possible. Finally, the clinicians and patients must maintain an open dialogue regarding evolving issues and new information as it becomes available. Although one of the greatest challenges in HIV medicine is dealing with uncertainty, honest and open discussions between patients and their healthcare providers are always the best place to start.