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Women's risk of transmission to neg male
Aug 18, 2000


I looked for my question but couldn't find it anywhere, so here goes. I am a HIV+ woman with undetectable VL below 50, CD in the 700's. My question is what is the actual risk of me transmitting the virus to my neg partner. What about oral sex performed by him? I know that the virus is supposed to be concentrated in the vaginal fluids. Also I am speaking of unprotected sex. After being infected for 2 yrs my VL upon initial testing, before meds, was only 350 copies. SO I am asking realistically what is the chance or the % value of risk of me passing it on to my boyfriend. I know safe sex is the best answer, but I would like the facts about unsafe sex with my levels. Thank you ahead of time for your answer. Also if you could, along with the medical facts, give me your personal opinion. Thanks again....


Response from Dr. Remien

First off, I need to remind you that I am not a "medical" doctor. And this is a question you should submit to The Body's Safe Sex and HIV Prevention Forum. However, you did also ask for my "personal opinion," and I know how anxiety provoking this can be, so I will give you my personal opinion.

The problem is that I don't think any expert can give you a % chance of you passing the virus on to your boyfriend. Studies that are done can only give you % risk based on a population - and that never tells you specifically what it means for you, because there are always individual factors that can affect transmission. There is evidence that a lower viral load reduces the risk for transmission; and oral sex is "less risky" than unprotected intercourse; and it is "less risky" for a male with an HIV+ female than the other way around .... However, with UNPROTECTED sex, risk remains. I know it is always frustrating to hear that, but it is the reality. When it comes to couples - it is always up to the couple to figure out what level of risk they are willing to live with. Anxiety and sexual pleasure do not go well together. So I advise you to accept the facts and the uncertainty that goes along with them - and figure out between the two of you what you can be comfortable with. Then try to stick to that, so you can otherwise relax and have fun.

Viral Load Test for Semen Secretions?
Tell my partner???

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