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FAQ: Why should you bother using condoms to prevent transmission when HIV is treatable?

for Veterans and the Public

Frequently Asked Questions

Q: Why should you bother using condoms to prevent transmission when HIV is treatable?

If I were given a choice, I would rather find out that I was HIV infected today, rather than 20 years ago. For people fortunate enough to be able to access treatment, combination antiretroviral therapy has changed the nature of HIV infection from a terminal condition to a treatable, chronic illness. Even though there is no cure for HIV infection, daily treatment has emptied the HIV wards of hospitals and has allowed people with HIV to feel well and move on with their lives. Each time researchers recalculate the average life expectancy of HIV-infected persons taking antiretroviral therapy, they arrive at a higher figure.

Nevertheless, would I rather have a chronic illness, or not?

I'd rather not.

I'd rather not take pills every day. I'd rather not worry that the medication will stop working. I'd rather not run the risk of experiencing side effects that some people get from the medications. I'd rather not worry about infecting my sex partners. I'd rather not increase my risk of getting other diseases such as lymphoma, coronary artery disease, and lung cancer that seem to be more common among HIV-infected individuals.

As with any life-changing experience, becoming infected with HIV has given some of my patients a valuable perspective on certain aspects of their existence. Nevertheless, almost all of them do whatever they can to avoid infecting others--they don't want others to go through what they have gone through.

I am very, very glad that HIV is treatable, both for my patients who are living with HIV and for anyone who becomes infected in the future. I'm also glad that antiretroviral therapy can not only keep people with HIV healthy but can prevent sexual transmission of HIV to negative partners. And I'm glad that we have condoms and PrEP (pre-exposure prophylaxis), which are very effective at preventing the sexual transmission of HIV when used correctly, so that all of us, whether HIV infected or uninfected, can help to reduce the number of people infected with or affected by HIV.

(See related question: If taking anti-HIV drugs has made your viral load undetectable, can you still pass the virus to another person through sex?)