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Why some people stay negative after HIV exposure
Oct 11, 2005

When I met my husband 3 years ago I was unaware that I was HIV positive. Within a year of the relationship I discovered that I was positive due to a infection of thrush which sent me to the doctor, but by this time me and my husband had unprotected sex numerous times. We had even had sex during my period. At the time we were having unprotected sex my CD4 cell count was 19, and my viral load was greater than 100,000. I am now undetectable with a CD4 cell count of 200+, but I still wonder why he never caught the virus from me. He has had numerous tests, and they have all come back negative. Why is that? Also, my husband is interested in having a child, but I am scared that the child would be positive, and that my husband could become infected if we try to have a child through unprotected sex. My husband feels that he hasn't caught it after all this time, so why not give it a try, but I am head-strong when it comes to protection now that I know my status, but I wonder if he could ever contract the virus from me ...

Response from Dr. Wohl

Thanks for your post. Some people are naturally more resistant to acquiring HIV than others. This is true for most infections.

There are a number of reports including those that have investigated sex workers in East Africa that have demonstrated HIV negativity even after repeated exposure to HIV. While absolute resistance to infection has not been clearly identified, it is known that people who produce less of certain T-cell proteins that HIV uses to enter cells are less susceptible to infection. Yet, even those with the lowest amount of these proteins can become infected.

Studies of discordant partners (where one is HIV positive and the other negative) have shown that over time more and more of the HIV negative folk become seropositive. So, your husband is lucky. Should he push it? I, like you, think not. I agree with trying to protect your husband, who should understand just how awful you would feel if he did contract this virus from you.

As far as becoming pregnant, there is no way to absolutely eliminate the risk of your transmitting HIV to an infant. The risk can be reduced dramatically with HIV therapy and perhaps C-section to the point that under ideal circumstances the risk of transmission falls from around 30% to 5% or a bit less. So, whether to become pregnant is a decision you must weigh given these facts. Of course, you need not have unprotected sex to become pregnant. Artificial reproduction clinics can help (for lots of money) as can a turkey baster (about $2.99 at Walmart).

DW



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