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Magnetic Couple Testing Recommendations
Nov 29, 2008

I'm a pos. female, VL undet. CD4 140 two years post diagnosis (probably 20 yrs pos.) I am 100% compliant on Atripla. My previous partner of 10+ yrs of unprotected sex who was uncircumcised is negative! (Go figure and he was the promiscuous one...I the faithful one) However I have just begun a new relationship with a wonderfully loving neg man whose reaction to me telling him about my status was just to kiss me and ask if I had any condoms! So we always use condoms for vaginal sex but do have unprotected oral sex based on my undetectable VL and estremely low atatistical risk (which I would not do if there were any visible blood anywhere). My question is about routine testing for him. What intervals would be recommended and is there anything else that we should/could be doing to ensure the contined magnetic relationship?

Thanks, and thanks for bringing levity to such a serious subject! You are my role model as I enter medical school myself!

Response from Dr. Frascino

Hi,

There are no firm guidelines for routine testing of magnetic couples. Some choose to test every six months; others, less frequently.

As for harm-reduction strategies, I'd suggest you and your Mr. Happily-Ever-After read through the chapter on magnetic couples in the archives. In addition to driving HIV plasma viral load to undetectable levels with antiretroviral drugs to significantly reduce the risk of HIV transmission (as you have already done), I would recommend having a starter pack of PEP (post-exposure prophylaxis) on hand for unanticipated or accidental exposures. Your HIV specialist may well be willing to provide this for your partner. You might also discuss with your HIV specialist PrEP (pre-exposure prophylaxis). Clinical trials are underway to scientifically assess the safety and efficacy of various PrEP regimens. Some HIV specialists are providing PrEP to magnetic couples now, even before we know the results of the clinical trials, as an extra measure of harm reduction.

Good luck. Happy Thanksgiving.

Dr. Bob



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