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(See resistance testing for an explanation of what it means for the virus to be resistant.)If an HIV-positive person is taking antiretroviral medicine and has an undetectable viral load, the risk of infecting someone else through sex is much lower than it would be if the viral load is high, but other factors (such as whether one of the partners has an STD) may increase the risk of HIV transmission.
Studies are going on right now to try to answer questions about HIV reinfection, but in the meantime, HIV-infected individuals will have to decide whether they are willing to take the risk not only of becoming superinfected, but also of possibly superinfecting someone else.
First, there are different types or "strains" of the HIV virus.
A person who's been infected with one strain can become infected with a second strain when exposed to it (such as through unprotected sex).
This is referred to as a second infection or "superinfection." It is not yet clear how often superinfection occurs, but it appears to be quite uncommon.
A person whose first HIV infection is relatively recent may be more susceptible to infection with a second strain.
Non-monogamy happens, sure — but to build it into a marriage is way too risky. The former are open to anyone; the latter are open to couples and single women.
There are more reasons for two HIV-positive people to avoid unprotected sex.
Unprotected sex allows the transmission of other sexually transmitted diseases (STDs), such as gonorrhea, chlamydia, and syphilis.
Pepper Schwartz: I was flipping channels the other night when I came across the nearly unwatchable Hall Pass (2011), a simpleminded movie with an even simpler premise: When the partners in a long-term marriage get sexually antsy, they start fantasizing — seriously fantasizing — about strangers.
And they become obsessed with the question, “Will I ever have sex with anyone but my wife/husband before I die?
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One couple in a very long marriage confided to me that they had always followed a “5 percent privacy” rule — a “Don’t ask, don’t tell” policy that freed each of them to devote one night in 20 to whatever they wished to do.