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Mixed Status Couple

Feb 11, 2009

Dr. Bob,

I was diagnosed in March of 2008, and at my last appointment I was told my VL had dropped to undetectable levels. I am proud to say that thus far I have been 100% compliant with my Atripla and I feel great. My fiancé has been wonderful, and the major reason for me not giving up. She has gotten tested several times since my diagnosis, and they have come back negative. We have a fairly active sex life consisting of protected vaginal and anal intercourse, as well as unprotected oral intercourse on each other. She has been going to get tested every 3 to 4 months. Is this enough? What would you recommend both as a doctor and a member of a magnet couple?

Thanks Glenn

Response from Dr. Frascino

Hi Glenn,

There are no specific rules or guidelines for this situation. Certainly with your Atripla driving your HIV plasma viral load to undetectable levels, the risk you could transmit the virus is significantly decreased. Latex or polyurethane condoms are protective, assuming they are used properly and don't fail (break). That leaves only unprotected oral sex, which carries only a very slight risk for HIV transmission/acquisition. Many magnetic couples in your situation test the negative partner every 6 to 12 months. Others may wish to test more frequently. Personally, I feel the 6-to-12-month cycle is fine. I would encourage you and your fiancé to read through the chapter on magnetic couples in the archives.

Be well. Stay well.

Dr. Bob

Symptoms tell you nothing
Risk when condom fails with HIV + man

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