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Ask the Experts about Mixed-HIV-Status Couples
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what are my chances of being negative?
Oct 25, 2005

My wife has been HIV positive for 8 years. During this time I had unprotected sex with her on several occasions (usually when we were drunk). On the 22nd August I tested positive for HIV (I got tested for HIV in Ugnada). I then got retested back home and I found out that I was actually negative on the 5th October).They retested me and I was definately negative. Unfortunately during this time period 22nd August- 5th October I did not use protection with my wife. We problably had sex fifteen times during this time (only vaginal) and once during her period. (Her period is usually small as she has a coil). At present her viral load is undetectable but went up to 53 copies in June. The doctor assures me that there is only a very small chance of infection but I am going crazy now having to wait three months for the window period to elapse. My greatest fear is the sex during her period. I have read that this is the time when a woman's viral load is highest in the vagina. But if her viral load is undetectable in the blood does this mean that the blood in the menestration is also negligible? I am healthy and free from any STD's. My wife is healthy also. I have read that the average time it takes for people to seroconvert is 22-25 days- is this true? What are my chances of being positive do you think?

Response from Dr. Remien

You are asking a complicated question AND I am not a physician. Thus I cannot give you a definitive answer on any of this. However, I will make a few comments, based on what I know, and I think may be helpful to you and other readers.

Viral load does seem to be a factor in likelihood of transmission (less likely with lower viral load), but there is ALWAYS a risk of transmission no matter what level of viral load because the virus is always present in blood and genital secretions.

There is not a one-to-one correlation between viral load of plasma (blood) and viral load of genital secretions.

The presence of other STDs does increase the risk of transmission of HIV.

Most people seroconvert (have measurable antibodies) within a few weeks to 3 months. Some can take longer. However, the sensitivity of the antibody test is improving which means the "window" in which antibodies are not detected is becoming smaller with advancements in testing technology.

It is possible to conduct a viral load test (PCR) to diagnose "acute infection." Acute infection is the period of time when someone is newly infected, but does not yet have measurable HIV antibodies. The test is not routinely done and is expensive. But it is being done in some research and clinical practice settings.

Continue to work with your doctor and I wish you luck. If you have any questions about behaviors that carry risk for HIV transmission, PLEASE speak with your doctor and/or an HIV counselor. You can also read the questions and answers on The Body's Safe Sex and HIV Prevention Forum

Finally, think about and talk with a counselor about ways of avoiding risky behavior when you are drinking!



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