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Undetectable untransmitable
Sep 2, 2017

Hello I am from Mexico and I have 7 years being positive with good levels of CD4 around 32% and VL undetectable and I have a couple he is also positive with the same numbers, recently we have been having sexual relations with no protection but never cumming inside. What are the real risk of having this behavior? I have read about the U=U study but it doesn't mention about a hiv couple. Could you give me please your opinion or advise.

Plead and thank you. I hope not to have a terrible English.

Response from Dr. Young

Hello and thanks for posting from Mexico. No te preocupes, tu inglés está muy bien.

In recent years, the science around HIV sexual transmission has been advanced. We have known for some time that any single sexual exposure actually carries a low risk of acquiring HIV. Indeed, there is scant evidence in the literature that transmission occurs with viral loads less than 1500. There are behavioral factors that can influence risk, such as the use of condoms (zero risk when used correctly); oral sex (no risk) or ejaculation outside of the body (lowers risk somewhat).

But most importantly, very large detailed sexual health studies have proven (in my strong opinion) that when a person living with HIV is on antiretroviral therapy and has viral suppression, that there is no risk of transmitting HIV. These studies documented the sexual histories of serodifferent couples (where the positive partner was on ART and virally suppressed) and in sum, after over 75,000 condomless sexual acts (tens of thousands among gay couples), there was not a single instance of linked HIV transmission. This concept has been furthered in the U equals U campaign.

So in your case, as long as you remain on treatment and have an undetectable viral load, you are indeed practicing safe, U=U sex.

Today's HIV medications work. Antiretroviral treatments prevent disease and death; they prevent transmission. Moreover, ART pre-exposure prophylaxis (PrEP) works to prevent HIV infection in uninfected people who are at risk for HIV exposure. It's for these reasons that ART is recommended by the World Health Organization for all people living with HIV, and PrEP is recommended for HIV-negative people who are at risk.

Espero que esta información es útil, BY

New diagnosis
PCV-13 and PPSV-23

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