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Follow up on ++ couples
May 19, 2008

Dear Dr Bob,

I was a little confused by your answer to a question on ++ couples. I am pos with a good CD4 count and stable % not yet on meds. My female partner is three years nearly on meds (GPO vir in Thailand)with undetectable levels and good CD4 count. Wehave used condoms 100% since we discovered our status. Should we continue to do so or can we dispense with them as we would like. Is the only problem concurrent infections or, as I have understood in the past,the possibility of different kinds of HIV within us mutating and creating resistance. We're quite used to condoms but...

Thanks for all the work you do here. I respect you.

Pos in Thailand

Response from Dr. Frascino

Hi,

Sorry for the confusion, although rereading my reply I'm not exactly sure what you are confused about. It's my opinion, based on the currently available scientific data, that superinfection (reinfection, dual infection) is indeed a real phenomenon. We unfortunately don't know how often it actually occurs, as it is difficult to pin this down in the laboratory (there are many potential confounding variables to sort out). It does appear to happen most often early in the course of infection. We also know that when someone's HIV viral load is suppressed to undetectable levels by using potent antiretroviral drugs, there is a significant decrease in viral transmissibility. Based on all of this, do I think you should forego condoms and safer sex techniques? No, at this point I would still be concerned about the possibility of contracting another strain of virus. In addition there is also the risk of unwanted pregnancy and the potential risk of other STDs.

Hope that clarifies things!

Dr. Bob



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