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Safe oral sex when on meds

May 7, 2005

Dear Dr. Frascino, I was diagnosed HIV positive in October of 2004 and began taking medication in December. Today I received my latest Blood tests results and my viral load was unmeasureable. Now that I've reached that goal I'd like to know if it is safe for me to let my negitive lover suck my dick, if I withdraw before I cum. I know that pre-cum could contain the virus, but what if the virus is unmeasurable.

My second question would then be if I am unmeasurable now, how common is it for the numbers to go back up? and if they did would that pose a risk to my lover.


Response from Dr. Frascino


Great news that your medications have driven your viral load to undetectable levels! As for if it's now "safe" for your lover to tongue lash your tallywhacker, well, in reality, no one can say for sure. As it turns out, even though your blood HIV viral load is nondetectable, your pre-ejaculatory and ejaculatory fluids might still have detectable (or at least active) virus in them. Consequently, we can't certify it's absolutely safe. That said, I will add that all things considered oral sex carries a very low risk for HIV transmission. That risk is decreased further by having a nondetectable viral load and by not shooting in your lover's mouth. Only you and your lover can decide what level of risk you are both comfortable with.

Regarding your second question, viral load may rebound for many reasons, including among other reasons 1) development of resistance, 2) non-adherence to medications, 3) intercurrent infections, 4) vaccinations and 5) reinfection/superinfection. You can read more about all these topics in the archives.

Good luck. Stay well.

Dr. Bob

Please explain PCR and results
Why don't you support more frequent testing?

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