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Being Undectable for 3yrs what are the chances of me passing HIV on - sex wise??

May 31, 2008

Hi Dr Bob,

I have been undectable for 3yrs now and my cd4 count is 770, I am on Saquinavir, Ritonavir, Kivexa, Lyrica and Zamadol. I was diagnosed 6months a go with Neuropathy which is under control now. The question is i have had partners who want bare back sex with me, and yes i have done it!! Yes they are all neg and still are, but i just dont understand what i can and cant do being Undectable?? Cheers.

Response from Dr. Frascino


Here's what we know. Using potent antiretroviral drugs to drive plasma HIV viral load to undetectable levels significantly decreases the risk of HIV transmission. However, what we do not know is if the risk becomes so low that it's essentially nonexistent. Most HIV specialists, yours truly included, would continue to strongly advise against bareback sex for several reasons. First, many of us feel HIV transmission may still be a very real possibility, even with an undetectable viral load. Second, there is no way to guarantee someone is undetectable at the time of sex, as HIV viral load may increase dramatically for a variety of reasons (development of resistance, concurrent infections, recent vaccine, poor adherence to medication dosing, etc.). Third, bareback sex puts both partners at risk of a wide range of STDs other than HIV that can affect the course of an HIV-positive person's illness and cause the neggie all sorts of discomfort. Fourth, barebacking can lead to unwanted pregnancy.

Remember, it takes two to do the unsafe sexual tango! My very strong advice to you personally is don't take the risk! Someone also needs to advise your clueless horned-up buddies that they are playing a dangerous game of sexual Russian roulette every time they decide to go Commando-Rambo by forgoing the latex condom.

Be well. Stay safe. Keep your partners safe.

Dr. Bob

Ouch She Bit It Off
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