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Risk of Transmission
Jul 4, 2002

I am a HIV+ male living with a HIV- Male. Just want to know some statistics regarding infection rates for unprotected anal sex. (Both Top and Bottom). We recently sliped up and had unprotected sex and we a re a bit worried abot the possible transmission. We did not come inside of each other, my viral load has been undetectable for the last 3 years. No obvious cuts or bleading was found.

Looking forward to your reply.

Response from Dr. Remien

Transmission of HIV is dependent on many factors, including viral load, condition of the mucous membranes of each partner, other health factors, and even perhaps genetic factors. While risk of transmission may be reduced when viral load is reduced, transmission is still possible. Remember, "undetectable" viral load simply means that it is lower than the sensitivity of the test used to measure copies of the virus. There is still virus present and it is always replicating. Also, the viral load that is measured is the viral load in the plasma (blood) may not be the same as the viral load of genital secretions - it can be different.

You should also be aware of "post-exposure treatment" which may be an option when there is an unplanned real risk for transmission having occurred. It is not something that can be used often and/or needlessly, but is recommended in some instances, but must be given within a very short window of time following the exposure. Speak with your physician and with your partner about this.


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