10 years with the virus: questions

[silvercompany]

Hey guys, first sorry about my terrible english, but I had an appointment with my doctor this week and I was not happy about it.

I got the Virus 10 years ago, and I was lucky to start medication just after I got infected. 

and to be honest, few years after I got infected I started to get fucked bareback in sex clubs/ saunas.

I always thought everything is Fine, and life goes on...

but....last month, I got syphilis and my doctor told me some stuff, that im not sure if is true ( or maybe is true, I just don't wanna believe it  )

 

1- he said even thought I ve been undetectable for 10 years, one day my medicaments are gonna stop working. That means, one day I ll have AIDS anyway?

2- he said that everytime I have bareback sex Im at risk of getting a new strain of HIV that can fuck up my treatment? So Im a little confused here: if I get a new strain,  that will most likely damage my treatment? Superinfection is real? 

3- He said that I have a higher likelihood of getting cancer and pneumonia because I am HIV-positive ( that is really true? because if im undetectable my body is normal? or am wrong? )

4- he told me to stop using DoxyPep because that will damage my responde to Antibiotic

if someone call help me with those question I would be very thankful 🙂

[757neg4poz]

You need to find a new doc because it's just flat out malpractice to suggest someone stop Doxypep. 

That said, superinfection is pretty rare if you are on meds. There are so many med classes on the pipeline that there will be no worries about reaching treatment failure with capsid inhibitors coming out.

Edited February 10 by 757neg4poz

[topblkmale]

 

2 and 4

Long story short - your doctor is advising you NOT to engage in bareback sex.

Either limit what you share with your doctor or find another one.

 

[cub84]

Can I ask what country or general region you’re from? I assume this is your regular general doctor, not an HIV specialist? Their knowledge is rather out of date, their advice feels much more like what you would expect in the 2000s rather than the 2020s. So, if it’s possible, I’d also recommend trying to change doctor. Perhaps get in touch with a HIV/sexual health charity in your city/country that can give you tailored advice based on the latest knowledge and research as well as options for changing doctors.

 

In regards to your specific questions:

1. Like many long term conditions it’s possible your current medication might start to be less effective, but there are several different classes of ARV drugs these days so I wouldn’t worry too much about this.

2. The multi-strain/super-infection risk is low. It was a widely held fear in the 90s/00s that “super infection” might be possible. Research has not shown this to be the case, it’s very rare and only documented in those not on medication.

3. It certainly is the case that folk with HIV/AIDS who are not on medication are at higher risk of pneumonia - a weakened immune system is likely to lead to more opportunity for a chest infection that won’t cure itself and thus develop into pneumonia. There is an increased risk of certain cancers but this has been reducing over time with the increased availability of better drugs to treat HIV.

4. If you have another infection that requires antibiotic then you may well need to stop taking DoxyPEP while you take the other antibiotic to avoid any bad interactions between the two drugs. But on taking DoxyPEP in general, it certainly reduces the likelihood of other STDs. There are many countries (France comes to mind) where there has been a long history of overprescribing of antibiotics and therefore significant fears about antibiotic resistance developing. But if you’re very regularly sexually active with multiple unknown partners then it probably is best to stick with DoxyPEP. A few hundred thousand gay men taking it isn’t going to add substantially to the pre-existing risks of antibiotic resistant super-bugs emerging.

[lower_bucks_bottom]

Get a different Dr. This one is clearly not up to date on the latest HIV science, and if not outright homophobic he appears to be trying to scare you.

And your English is fine

[viking8x6]

19 hours ago, silvercompany said:

1- he said even thought I ve been undetectable for 10 years, one day my medicaments are gonna stop working. That means, one day I ll have AIDS anyway?

2- he said that everytime I have bareback sex Im at risk of getting a new strain of HIV that can fuck up my treatment? So Im a little confused here: if I get a new strain,  that will most likely damage my treatment? Superinfection is real? 

3- He said that I have a higher likelihood of getting cancer and pneumonia because I am HIV-positive ( that is really true? because if im undetectable my body is normal? or am wrong? )

4- he told me to stop using DoxyPep because that will damage my responde to Antibiotic

I am not a medical doctor. I do, however, have a doctorate in science and a fair bit of knowledge on these topics.

1. one day your treatment might stop working (if your virus evolves a resistance to it). BUT - there are many classes of antivirals available now, so another treatment will probably still work if that happens AND it is quite possible (even probable) that you will die of something else before your treatment stops working

2. superinfection is an old theory, and has been observed in practice to happen very seldom, especially if you are on HAART treatment (which effectively acts as PrEP against other strains with which you might come in contact)

3. that's possible if you are immunosuppressed. If you are undetectable and your immune system is working properly, I see no reason to think that your chances of getting cancer or pneumonia would be significantly higher.

4. that's nonsense. DoxyPep can in theory cause any bacteria you have at the time you take it to become resistant to doxycycline. That risk is not very important with occasional use because doxycycline resistance is already common in many kinds of bacteria. Certainly your body will not "develop a resistance" - that's something the bacteria do, and if you don't have them, they won't do it.

Bottom line: As others have said, get a different doctor.

[PozBearWI]

And it's important to note that unless you're having anonymous sex every day; and sadly at least many of us don't; you only need doxyPEP in proportion to your exposures.  And in that case, just wait until the infection to treat it.  I have doxyPEP in my cabinet.  I have had occasion to use it.  If you're ever going to take it and a newly prescribed antibiotic, by all means bring up the fact you've been taking doxy every day so he can take that into account (although, TBH, he'll know by your refill activity.  )

Echoing above, your doctor did a bang up job disqualifying himself.  

WRT !.  treatment failure.  Sometimes one cocktail simply stops working as well.  Numbers in your labs start to change suggesting the cocktails are lessening in effectiveness.  And in that case exploring other ones is often the remedy.  It would be uncommon for there to be a sudden failure, but uncommon things can happen.  Biktarvy has been around 20ish years now, and many remain on it with pretty darned good periodic labs.  But it is hardly the only option.  

Edited February 10 by PozBearWI

[fisterm8]

On 2/9/2025 at 11:39 PM, silvercompany said:

Hey guys, first sorry about my terrible english, but I had an appointment with my doctor this week and I was not happy about it.

I got the Virus 10 years ago, and I was lucky to start medication just after I got infected. 

and to be honest, few years after I got infected I started to get fucked bareback in sex clubs/ saunas.

I always thought everything is Fine, and life goes on...

but....last month, I got syphilis and my doctor told me some stuff, that im not sure if is true ( or maybe is true, I just don't wanna believe it  )

 

1- he said even thought I ve been undetectable for 10 years, one day my medicaments are gonna stop working. That means, one day I ll have AIDS anyway?

2- he said that everytime I have bareback sex Im at risk of getting a new strain of HIV that can fuck up my treatment? So Im a little confused here: if I get a new strain,  that will most likely damage my treatment? Superinfection is real? 

3- He said that I have a higher likelihood of getting cancer and pneumonia because I am HIV-positive ( that is really true? because if im undetectable my body is normal? or am wrong? )

4- he told me to stop using DoxyPep because that will damage my responde to Antibiotic

if someone call help me with those question I would be very thankful 🙂

Why would you be on doxyprep if uve been on meds for 10 years? 

[Poz50something]

2 hours ago, fisterm8 said:

Why would you be on doxyprep if uve been on meds for 10 years? 

Anti retroviral medication is to stop the human immunodeficiency virus from reproducing. Doxyprep is to prevent bacterial stds from invading the body. 

[PozFunBER]

On 2/10/2025 at 12:39 AM, silvercompany said:

Hey guys, first sorry about my terrible english, but I had an appointment with my doctor this week and I was not happy about it.

I got the Virus 10 years ago, and I was lucky to start medication just after I got infected. 

and to be honest, few years after I got infected I started to get fucked bareback in sex clubs/ saunas.

I always thought everything is Fine, and life goes on...

but....last month, I got syphilis and my doctor told me some stuff, that im not sure if is true ( or maybe is true, I just don't wanna believe it  )

 

1- he said even thought I ve been undetectable for 10 years, one day my medicaments are gonna stop working. That means, one day I ll have AIDS anyway?

2- he said that everytime I have bareback sex Im at risk of getting a new strain of HIV that can fuck up my treatment? So Im a little confused here: if I get a new strain,  that will most likely damage my treatment? Superinfection is real? 

3- He said that I have a higher likelihood of getting cancer and pneumonia because I am HIV-positive ( that is really true? because if im undetectable my body is normal? or am wrong? )

4- he told me to stop using DoxyPep because that will damage my responde to Antibiotic

if someone call help me with those question I would be very thankful 🙂

Wow , your doc seems to be very uninformed. Luckily my doc is member of the German HIV/AIDS Association, frequently traveling and speaking at conferences. He gives me frequent updates. You def should get another doc 🤷‍♂️ 

1 - wrong , while there is a chance that your meds might have reduced effect after time, nearly every year new medications are developed and coming on the market – I switched meds already 3 or 4 times to get “an update” , meaning new meds with even less side effects

2 - true you can get different other strains but only if they are super toxic / mutated versions / think of HIV meds a little bit like broadband antibiotics

3 - if you are taking HIV meds and you are undetectable you are - frankly speaking NOT HIV positive. While we use this term to define our status (as HIV can not be healed) , the likelihood of getting cancer is as high as for any other person. High blood pressure and diabetes are more dangerous! Focus on a healthy lifestyle. If you eat McDonalds every day, of course you get cancer - but not because of being HIV poz.

4 - that’s actually a rather smart consideration. Antibiotics are no jokes. My docs opinion: don’t play with antibiotics. There are moments in life when you really need them. You don’t, when you have some clamydia for some weeks. My agreement with my doc: I can be slutty as I want but I see him once per quarter to get fully checked for any STD - and if , I get treated. Done. 

[Pozguyinchi]

I hope you have not been seeing this Dr. the whole 10 years. Choosing the best Dr. is key. My Dr. is not an HIV specialist but is Gay and his partner is POZ. Our conversations are easy because I don’t need to hold back. He knows there is no way I will have let a condom go into my body and the volume of men that use me annually. He does a great job educating and informing me of what he knows and his personal experiences. I know there are many more Dr. like him out there. You need to find one that works best for you. 

[NYBBGUY58]

I agree with all prior comments. While there are risks involved in bareback sex,  as long as you're on medication and your viral load and T-cells are at decent level it will be okay.

Shop for a new doctor, one who doesn't seem to have an agenda that "BAREBACK SEX IS BAD!" I stopped going to a particular urgent care center after getting a lecture when I needed treatment for gonorrhea. That is a risk of sex without condoms, one that I'm okay with paying. I personally can't tolerate Doxy prep, and have been sidelined by treatment for prostate cancer just now anyway (NOT RELATED TO HIV).

If it's any comfort at all, similar objections were voiced when birth control pills became available. While those have some clear medical risks as it turned out, a chunk of it was just moralistic bombast about the world going to hell in a hand basket because contraception was now simpler. We live in a sex-averse society that bombards us with messages about being sexy and attractive, but heaven forbid you enjoy yourself. I'm sorry you have to deal with a medical cretin.

Edited February 11 by NYBBGUY58
Clarification/correction.

[BootmanLA]

21 hours ago, fisterm8 said:

Why would you be on doxyprep if uve been on meds for 10 years? 

You are making a common mistake.

DoxyPEP - notice that there is no "R" there - is for Post Exposure Prophylaxis - treatment AFTER possible exposure. When used with "Doxy", it's referring not to HIV, but to other, bacteriological STI's like syphilis. The point of DoxyPEP is to prevent an exposure to one of those STIs in a sexual encounter from infecting you.

When this is used for HIV exposure - for someone who just had unprotected sex and didn't intend to, or had a needle stick from an unknown source, or whatever, PEP is used to prevent HIV from taking hold AFTER the exposure. It consists of a double-dose of the same medication used in PREP, then a 30-day regimen to (hopefully) conclusively prevent HIV from taking hold in the body.

PrEP - THERE'S that "r" - is for PRE-exposure prophylaxis. It's not normally used for antibiotics, etc. because we don't want to develop antibiotic-resistant strains of bugs that we normally can treat pretty readily. So there is NO SUCH THING as "DoxyPrEP".

But because of the potential consequences of HIV infection, we DO use PrEP for HIV prevention. 

[PozBearWI]

Adding to @BootmanLA 2-1-1 use of PrEP has been approved for some time now.  Meaning even that doesn't necessarily have to be taken daily unless you have raw anonymous sex daily.  IF that is the case it would be worthwhile do discuss with your doctor how to manage your comparatively unique case with your doc.