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Not infectious?
Apr 5, 2002

I realize this is long, but please help me. I was with three women before I found out that I was positive that I still keep in contact with. I have traced my infection to 21 years ago when I experimented and had a homosexual affair (the only one I ever had) and soon afterwards I had a herpes like infection on my penis and groin area. I was tested for everything at the time, but there was no HIV test in 1980. The infection came up a couple of times in the following year and never came up again. Soon after that infection I was with a woman for three years, I then was with another for one year and one more for three months. There have been others, but these are the only three I am still in contact with. None of these three women are infected. I found out my status 11 years ago. My T-Cells were then about 1100. Now they are over 800 and I have an undetectable viral load. I have been on the meds only the last three years. How can it be that these three women are not infected? It has been years since I was having unprotected sex with them so they should have come up positive by now. I am absolutely healthy and asymptomatic. The only thing hurting my life is that I am now in love with a woman that is negative and she is afraid to be with me. We are both in love with each other and both want a family and kids but she is afraid of getting infected. Is it possible that with my high T-Cell count and undetectable viral load that I am not infectious? All the stories that I have heard lead me to believe that someone has to be in an infectious state to pass this on. That while you can't rule it out 100, there is very little chance of my passing HIV to her with my high T-Cell count and undetectable viral load. I read a study that was done in Africa that put together men that were positive with undetectable viral loads, with women that were negative and none of the women turned positive. I appreciate your answers and thank you so much for your help.

Response from Dr. Remien

The study you refer to showed that among HIV serodisocordant couples in Africa, viral load was the biggest single predictor of HIV transmission within the couple. That is, the lower the viral load the less likely it was for HIV to be transmitted. So it seems that amount of virus being replicated in the HIV+ person's body does play a role in likelihood of transmission. However, no study suggests that it is impossible for HIV to be transmitted with a low (or undetectable) viral load.

The best one could say about your history is that you and your partners have been lucky for HIV to not have been transmitted. Unfortunately, you cannot consider yourself to be "not infectious." Consistent and correct use of condoms is your best preventive measure. Staying in good health will also help.


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