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Ask the Experts about Mixed-HIV-Status Couples
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higher viral load =higher risk?
Jul 31, 2002

My partner of 12 years was just diagnosed with AIDS.We both knew his former boyfriend was HIV+ but my partner must have got tested too soon after last having sex. Anyway, its a miracle that after being with him for the last twelve years and assuming a neg. status and having constant unprotected sex (we are monogomous) that I am hiv neg. My question is his viral load is through the roof and his cd4 is 90. He is just getting over pcp and has herpes in his mouth and on his back and re-occuring thrush. He just started his meds 2 days ago.I know our world has been turned upside down by this but I don't want him to think I am afraid of him. Is it safe right now with his numbers to be intimate? I am more afraid of giving him something -like a cold or flu- that right now might kill him. He knows and trusts that I will be with him until I die of old age (thats our joke because he is 34 and i'm 41) but its important to me that he knows I still find him the man of my dreams.

Response from Dr. Remien

You are indeed lucky in that you have not become infected. Both a higher viral load and the presence of other co-infections - particularly any open sores as occurs with herpes - raises the risk for transmission of HIV to you and also transmission of other infections to him. However, I don't think you need to worry about a cold or flu that he might get is going to "kill him." Bottom line is that safety and protection are in order for both of your sakes. I suggest that both of you have a conversation with his physician about the best ways to safeguard optimal health for each of you. Letting him know that you love and want to support him is an important thing to communicate to him, if that is indeed how you feel.



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