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Undetectable & HIV Transmission Risk
Jan 4, 2008

What is the "reality" of HIV transmission from an HIV Poz guy who has an undetectable viral load and currently on medication? I know from what I read it is still possible, but does the chance of transmission go down dramatically in your opinion if you are undetectable? The concern is my condom broke while being intimate with my boyfriend and I did not realize it until the fat lady sung as it were. So, we are both a little concerned to say the least.

Thanks for your opinion and your on going sense of humor, I love reading all your posts! Its so educational for a newbie like me. We both hope you are having a great holiday season!

Response from Dr. Frascino

Hi,

So your Top Gun boyfriend is a singing fat lady???? Hmm . . . OK, whatever gets you thought the night guy.

Regarding HIV-transmission risk, yes, driving the plasma viral load down to undetectable levels significantly decreases the HIV-transmission risk; although it does not completely eliminate it. Some magnetic couples would opt for nPEP (nonoccupational post-exposure prophylaxis) in situations like yours; others would forego nPEP, because the risk is presumed to be quite low. PEP is most effective in aborting a possible HIV infection if it is started as soon as possible and no later than 72 hours after the exposure. PEP or no PEP, you'll still need HIV testing. Your boyfriend's HIV specialist may well arrange this for you. He might also supply you guys with a starter pack of nPEP just in case the fat lady decides to sing again sometime in the future.

Good luck and Happy Healthy New Year's to both you and your singing stud puppy.

Dr. Bob



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