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Possible infection, longterm non-progression, and seeking help in Australia
Oct 7, 2003

Dear Robert, A couple of weeks ago, I was told by my partner that he is HIV+. He is a "long-term non-progressor. I have done a bit of research on the internet, and found some articles about serodiscordant couples, and found you are quite an expert in this area, so I am hoping that you could give us some help.

Are you aware if there is any project in Sydney for HIV mixed status couples?

What sexual practice is considered risky? I know the level of risk is perceived differently by different people, but is there any general information? For example, is unprotected oral sex with the negative partner being receptive (without ejaculation) generally considered risky?

What is the life expectancy for a long-term non-progressor? Is it too optimistic to think that they will be asymptomatic for the rest of their lives?

Also can I find out if I were HIV+, whether I will be a long-term non-progressor

Thank you so much for your time.

Response from Dr. Remien

I am not aware of any specific programs for specific services in Australia for mixed status couples. However, if you have not already, you should contact the AIDS Council of New South Wales. It has a full range of programs including counseling and support services, prevention resources and drop-in programs. It also has a suite of PLWHA programs as well. Its URL is:

AIDS Council of New South Wales

Contact details can be found by following its links. Staff there can also link you to the appropriate program in ACON or to related agencies, such as PLWHA(NSW) - the main HIV+ organization for your partner.

Regarding your questions:

You are right - perception of risk is different for different people, including the "experts." Generally, oral sex is low on the hierarchy of risk, especially when no ejaculation is involved. However, as you probably know, nobody can reliably tell you that there is zero risk. You (and your partner) need to do what you are comfortable with. And to figure this out, you need to have the basic facts and then incorporate what you find out into what you both find pleasurable. The general website of The Body is a good start for basic information. Make sure you visit the expert forum on Safe Sex.

On the issue of "long-term non progressors (LTNPs):" Many people can live very long, without illness and without medication therapy. Many others can live very long, without illness, but require therapy (antiretroviral medication). People living with HIV now (as opposed to 8 or more years ago) who have access to good health care and medications can anticipate long and healthy lives while living with HIV. There are many reasons that people are LTNPs. They include the genetic make-up of the person infected, the health and specific factors of the immune system of the person infected, the general health of the person infected, the strain of virus with which the person is infected, and probably other things we don't fully understand. Any or all of these factors can contribute to LTNP. This means that your partner's health status cannot directly predict what your health status would be if you were to become infected. Only time living with HIV can really tell if one is (or will be) a LTNP. Anyone who is infected should see their doctor regularly, and also have basic tests done (e.g., viral load, CD4+ count). What is "regular" differs, depending on the person. One's doctor should be able to inform the person how often they need to be checked. The average time between check-ups for people who are asymptomatic (not ill) is every 3-4 months. See the medical information provided at The Body's main website and other related links, including the agencies in Australia.

You need to know that you are not alone with your questions, concerns and issues. Talk to others, including your partner and get whatever other support you need for yourself.

I hope this is helpful.


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