Reinfection

[Sebasteans]

Last December I found out I was positive. I've been on meds since then and am now undetectable. When they discussed how the meds work, they talked about reinfection from another strain of HIV. I'm curious if anyone who has consistently taken their meds and taken poz or undetectable loads run into this issue. Thanks!

[jtonic]

I think this article answers your question well:

 

What is HIV superinfection (reinfection)

 

I've been poz for almost a year, undetectable, and discussed this topic a lot with health professionals and support groups. There's no clear consensus.

[bearbandit]

If you're on treatment and it's going well (as in you've got your viral load down to undetectable), you're effectively on a superior form of PrEP as far as HIV is concerned. So you get fucked by a guy with a strain of HIV that's resistant to one of your drugs. The other drugs you're taking are going to hit it. And that's if the new HIV even gets as far as trying to establish a new infection. One reason that PrEP works is that virus that's resistant to both emtricitabine and tenofovir is incredibly rare: it's only been seen a few times.

 

Another thing to remember is that resistant virus is weakened virus. In time the wild type (non-resistant) virus crowds out the resistant virus, which is why many drugs can be re-used some years after someone's virus became resistant to them. The main reason for changing drugs is because of interactions and side effects: resistance is rare, but it does happen. The chances of getting laid by a guy whose virus is resistant to even two of your drugs is pretty remote.

 

My personal feeling is that syphilis, gonorrhoea etc represent a far greater risk to my health than the extremely remote chance of taking on board a load that's resistant to all the drugs I'm on. In one respect it's time to go back to the seventies when the standard advice from any gay helpline was that sexually active gay men should be having a full STI workup every three months whether they have symptoms or not. STIs can do enough damage to people who don't have HIV, we're more vulnerable to them and a number of them have no noticeable symptoms...

[sweetbitch]

Thanks, Bearbandit, for taking time again to help us all. Thank you especially for explaining why once I was told I had resistance to one of the drugs in my cocktail (although it still boosted another drug's potency), but years later there was no resistance anymore.