The recent international conference on AIDS held in Barcelona generated very little to be enthusiastic about on the AIDS front particularly for those parts of the world much more impacted than the USA and Western Europe. One particular piece of news though that should be particularly disturbing to those of us privileged enough to have access to HIV medicines is the now apparently confirmed hypothesis that re-infection with another strain of virus is possible. In other words you can be HIV positive with one version of the virus and then be infected again with another version; this of course becomes a real bummer if the “new” strain of virus is resistant to drugs your original strain is susceptible to.
This is not a new concern and until recently was felt to be a distinct possibility, but it now seems to be definitely something that can and does happen. The specific case involved a Boston man who was not on HIV medicines but had good T-cells and was containing his virus well. After having unprotected sex with another HIV positive man the researchers were able to document that he had been infected with a second strain of HIV. He was unable to control this second strain and T-cells fell and viral load increased. The major long term ramifications of this are related to vaccine development, making that potentially much more difficult. The immediate concern though for many of us is the now documented risk of unprotected sex between HIV positive people, primarily anal sex.
Another confirmed piece of information that makes this even more disturbing is the fact that many newly infected folks, particularly gay men in this country, have versions of the virus already resistant to many of the drugs currently used to treat HIV. That may mean if you have been infected recently these drugs might not work as well as they could.
If you have recently tested positive though do NOT take this new information as totally bad news and avoid close monitoring and treatment. One of the things we have learned in the past ten years is that even therapy that is not “perfect” still seems to help the body keep the virus contained enough for many people to benefit significantly, often for many years!
So what does this mean for Poz on Poz sex? Well that depends. Don’t you hate that answer? Concern about this can be dramatically reduced if you use condoms for anal sex. One real danger would be to have sex with anyone positive who comes along and engage in anal sex figuring the condoms are unnecessary. This is no longer a good idea!
Quite frankly I have not thoroughly thought through all of the implications here especially when it comes to individual counseling around specific circumstances. As an HIV+ man in a relatively long term relationship with another HIV + man, with both of us on very different HIV medicines, and condom use has not always been 100%, I am not sure where to take this! Probably back to the store for more condoms for now! Stay tuned!