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Portuguese wohoing guy needs help on prevention issue [resubmitted form the Fatigue and Anemia Forum.]
Jan 19, 2007

Hey doctor, hope u are doing well! your brother also.

I am, as i told u i would do, taking a role on prevention here in Portugal. I got in a discussion about Viral Loads; a guy said that if someone is undetectable the HIV concetration on semen also goes down making it almost safe to have sex.

I read a reply from u saying that recent studies say there is no correlation.

I urge u help me on this matter; could u answer the question to confirm what i think... or deny it :P

and please could u give me a reliable source. It's the major online forum here on Portugal with thousands of people there.

It's very important, plz help me doc.

My best regards,

Portuguese Wohoing guy

PS: sry for having sent this to the wrong spot :P

Response from Dr. Frascino

Hi Portuguese Guy,

There aren't a lot of good clinical studies addressing this specific question. What we do know is that in general when the plasma viral load goes down, so does the seminal fluid viral load. However, that decrease in seminal fluid viral load does not always parallel what's happening in the blood. Also, we know that even if the viral load decreases in both seminal fluid and blood, this does not mean the person is not contagious. HIV can still be transmitted. Unprotected sex, even with an undetectable viral load, is still high-risk sex. As for a "reliable source," there are absolutely no reliable sources that would ever recommend unprotected sex as safe no matter what the viral load happens to be. See post from the archives below. Finally please remind your readers there is no such thing as "almost safe" sex as far as HIV/AIDS is concerned.

Good luck educating all those horned-up Portuguese studs!

Dr. Bob

hiv viral load in semen versus blod Nov 30, 2006

Hi Dr. Bob,

Please settle a dicussion I've been having on an hiv information site to which I subscribech higher is the viral load in semen versus blood ? I read a study a while ago stating it could be hundreds of times higher in semen, but I can't find the article in the stack of printouts on my desk. Can you settle this question ? Thanks, btw I enjoy your strange but true columns. Bertbear

Response from Dr. Frascino

Hello Bertbear,

Recent studies show that HIV viral load in blood plasma and ejaculate are generally well correlated. True, there have been some studies that have found detectable viral loads in seminal fluids, despite undetectable plasma viral loads. These may be the studies you were referring to. These reports garnered some attention awhile ago, because they help reinforce the notion that despite an undetectable viral load an HIV-positive person is still infectious and must adhere to safer sex precautions.

Stay well, Bertbear

Dr. Bob



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