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low risk+low load=longer window period?

Apr 6, 2007

Dear Dr Robert,

I hope you can help me. I believe I am one of your so called "worried well" 36 Days ago I had the good fortune to engage in sexual acts with two chaps. I had protected anal and unprotected oral, I did swallow (well they showered me to be precise!) a week later I did the same thing with another lovley young thing. Whilst recounting my exploits to my friends I am told that oral is now a considered risky. With that in mind I did a p24 and HIV antibody at 18 and 26 days repectively and a HIV antibody at 29 and 37. Now they were all negative, but my question (finally!) is there any correlation between the length of the window period and the detection of antibodies in the system, or another way because of the low viral load exposure does it take longer to sero convert. I will of course make a healthy donation if you answer my question. Nonetheless you are doing a first rate job and I think the position you take on these matters to reassure people is a credit to your profession, yes I admit that was a little brown nosey to get printed but true all the same.

Response from Dr. Frascino


The level of plasma HIV viral load may affect the ease of transmissibility, but it would not affect the duration of the window period. In other words, a low or undetectable viral load decreases the risk of viral transmission. However, if someone becomes infected, the viral load of the source patient is not a factor in how long it takes the newly infected person to develop detectable levels of anti-HIV antibodies. Once HIV gets into our system, viral replication can really take off up to 10 billion replication cycles per day. So to specifically answer your question, neither "low risk" nor "low viral load" affects the duration of the window period once infected.

Finally, regarding donations, healthy or otherwise, they should be given only in the spirit of compassion and generosity. Donations to The Robert James Frascino AIDS Foundation are always welcomed, but they are not related to and do not affect which questions are selected for posting. My work here on The Body is free and available to all.

I should also mention, I do not agree with your friends that "oral is now considered risky." In fact, the more we learn about the HIV risk of oral sex, the less risky it becomes. Check the archives and you'll see what I mean.

Good luck.

Dr. Bob

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