Hello, Thanks Dr. Bob for everything. You have truly helped my boyfriend and I through a tough time. I love the "Magnetic Couple" moniker that you have assigned to serodiscordant couples!

My boyfriend was diagnosed HIV+ in December, and we had only had unprotected sex once (the heat of the moment) up to that point.

Since then, we have only had protected sex and our sex life is great.

I want your opinion both as a medical professional and part of a magnetic couple, how often should I be tested?

I wonder if I should only be tested if the condom fails, or some other exposure happens, or if I should be tested every 6 months or more often.

He is under the care of a good HIV specialist who has done my testing up to this point (HIV- at the three month mark!). Should I ask him about writing a prescription for PEP that I could have on hand in case a condom were to break?

Hello,

Welcome to the wonderful world of magnetic coupling where opposites definitely do attract!

How often you should test is really a personal decision based on comfort level and risk. What I can tell you is that HIV cannot permeate a latex condom. No way. No how. Consequently, if latex condoms are used properly and don't fail, your HIV risk should be essentially nonexistent. Some guidelines suggest sexually active folks (multiple partners) should consider STD screening (including HIV) every six months. However, if you and your boyfriend are monogamous (and I don't know if you are or not) and use condoms properly, these guidelines may not apply. Certainly if a condom fails or if you have a significant exposure (for instance another "heat of the moment" event), then of course you'll need testing, monitoring and, depending on the risk, PEP. Some magnetic couples have a PEP prescription ready in case a significant unavoidable exposure occurs. Personally, I think this is a good idea. There are also studies in progress examining PrEP (pre-exposure prophylaxis). This involves taking antiretroviral medications on a regular basis for those at higher risk of exposure. Whether PrEP is safe and effective is still being determined.

I'm glad your boyfriend is under the care of an HIV specialist. I should also point out that if his viral load is low (hopefully undetectable), he is considered less infectious, i.e. it's more difficult to transmit HIV if the viral load is suppressed to undetectable levels.

Good luck to you both. From one magnetic couple to another, stay well and be happy.

Dr. Bob (and Dr. Steve)