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Table of Contents

Standing in the Shadows of Love

The Great Doctor / Patient Face-Off

Mailbox

Boy Talk

Girl Talk

Name Recognition

Dynamic Duos

Work That Visit!

It Takes a Villager

Urinetown

Devil in a Blue Dress

U.S. Armed Cervixes

Cell Culture

Milestones

Class Act

Good Book

Rape OutRAGE

It Happened in September

Hitting the Switch

Missed Doses

Overexposed

Count Down

Tailgating HIV

20%

Potty Mouth

Booty Call

London Calling

Test Drive

Aid for Medicaid

Editor's Letter

Lei'd in the Shade

The Wings Beneath His Wind



Most Talked About

AIDS: Not a Heterosexual Disease? (46)

The Greatest Gay Rights Battle of Our Time (Blog) (19)

Lambda Legal Responds to HIV Spitting Conviction (19)

Ready to Quit? The Risks and Rewards of a Potent Smoking-Cessation Drug (17)

Mandatory HIV Tests Before Marriage? (15)

Most Popular Lessons

Herpes Simplex Virus

Syphilis & Neurosyphilis

Shingles

The HIV Life Cycle

Human Papilloma Virus (HPV)

Treatments for Opportunistic Infections (OIs)



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September 2003


Overexposed

by Chris Michaud

If you and your boo are both HIV positive, and you’ve deep-sixed the condoms because you think the risk of superinfection is a myth, yet another new report may give you pause.

In May, AIDS reported that a California man was superinfected with drug-sensitive (“wild type”) HIV four months after contracting a drug-resistant strain. Lab work proved he hadn’t gotten both strains simultaneously, and the new infection spiked his viral load from 2,400 to nearly 200,000, as his CD4s dropped from the 800s to the 200s in a year—courtesy of the more virile “wild type.”

With most viral diseases, the immune system builds barriers to superinfection (that’s why mumps and measles strike only once). But scientists have long deemed HIV reruns possible, even likely, because the virus acts like the common cold or flu—constantly mutating, or reinventing itself. The immune system reads each new version as unique, so your response to the first strain doesn’t protect you against any sequel.

Over the past year, only a handful of HIV superinfections have been confirmed by lab analysis—precisely why some HIVers say that same-serostatus skin-on-skin sex is a risk worth taking.

Others warn that superinfection could speed disease progression or help spread drug-resistant HIV, limiting treatment options. In one case, the superinfection strain differed by only 12 percent from the original HIV but still evaded the immune system’s detection. As Joseph Sonnabend, MD, says, “There is a documented danger, though no one can quantify it. It means positive couples shouldn’t assume safe sex doesn’t matter.”


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