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comment not question
Apr 14, 2007

Dear Dr Bob, I have to disagree with you when you say there is tangible (I'm paraphrasing) risk to having unprotected sex if one partner is negative and one partner is positive but undetectable. The risk is "minimal" (see link to article, below). Hetero magnetic couples have sex without barriers and become pregnant. The negative partner stays negative if the positive partner is undetectable. Check out http://www.aidsmeds.com/articles/1667_10825.shtml or go to poz.com and search "undetectable pregnant". Thanks, Sam

Response from Dr. Frascino

Hello Sam,

Actually Sam, I don't think there is any incongruity here, even accounting for differences in semantics. If you agree the risk is "minimal," that is not at all inconsistent with there being a "tangible" risk. Minimal is not nonexistent! I agree having an undetectable viral load decreases the risk of HIV transmission, but it certainly does not eliminate it! Your statement that "hetero magnetic couples have sex without barriers and become pregnant" without infecting the negative partner if the positive partner has an undetectable plasma viral load can be true in many situations but definitely not all! Remember, not every exposure to HIV results in HIV transmission. In fact, the vast majority do not, even with a detectable viral load.

So, Sam, you can disagree with me if you like, but if you believe an undetectable plasma viral load provides absolute protection from HIV transmission you would be wrong dead wrong. Risk, be it "minimal" or "tangible" is risk. And the risk we are discussing, which can have disastrous consequences, can be easily prevented by properly using a latex condom. I urge you to review the literature a bit more critically and also urge you to continue to use latex condoms if you are part of a magnetic couple. By the way, I practice what I preach.

Dr. Bob



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