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How big is the risk?
May 24, 2002


Excuse me that I ask you there in the U.S.A. But here in Germany is no answer to get for what I want to know.

Im a German married with a lady from Uganda. Short before our wedding one year ago we came to know that shes HIV +. Not only this - she had have already AIDS. Nevertheless I married her. Our relation before our marriage took around one year. We had very often very intesive Sex without kondom because we didnt know about her situation. More - we had a certificate from Kenya that shes HIV -. But it was not true. They made a mistake there. How can it be, that I didnt get an infection in this time? When the doctors here in Germany discovered her status - she was very sick; almoust to die; virus-load 300.000/ml and cd4-cells only 3/microliter - we stopped after her recovering unprotected sex. But now, because shes feeling well and the status is: virus-load under the border of evidence; cd4-cells 130/microliter we do from time to time again sex without kondom. Please tell me, if Im right with my opinion, that there is only a very small risk of getting an infection because the virus-load is almoust zero. Am I right or have I to stop this risk. Or can it be that Im immun against HIV, that Im similar like vaccinated because of oftem contact with the virus?

Than you very much, A.

Response from Dr. Remien

There are a number of hypotheses about why a person who is exposed to HIV remains negative and they include things such as viral load exposure being very low, a natural genetic immunity, a strong antibody response that is operating to prevent actual infection, an attenuated (weakened) virus, etc., etc. And a "lucky" couple may have more than one of these things happening. But I don't think any expert would say that a couple like this is immune to transmitting HIV between them. It may be that they've just been lucky, so far.

Since your wife is HIV+ and you are not, protection should be used so that you do not become positive. You've been lucky so far, but there is no guarantee that will continue. Be safe so that you don't have to keep worrying about becoming infected.

hiv positive hemophiliac

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