I have recently met the most beautiful man. We have been slowly and perfectly falling in love for the past 7 months. I have been HIV+ for about a year and a half. I am not on medication and my CD4 is in the 700's. My viral load fluctuates between 5,000 and 18,000. We have not had sex yet, he is negative. He is a top, I am a bottom. I am considering getting on medication to make my viral load undetectable for his safety. I am wondering if I am a positive bottom and he is negative and a top, and I am on medication, is okay for us to be having unprotected sex? Thank you very much!

Hi,

Unfortunately no, it is not. Certainly driving your plasma HIV RNA viral load to undetectable levels with effective combination antiretroviral therapy will significantly decrease the chances of HIV transmission, but it does not eliminate them. Condoms are still essential for all penetrative sex. Without them, you're playing sexual Russian Roulette with your "most beautiful man's" health. I strongly suggest both you and your Mr. Right read through the chapter in the archives of this forum devoted to magnetic couples. Please note, I, too, am involved in a magnetic coupling, and I can tell you from our 16+ years of experience, "happily ever after" does exist for magnetic couples, including hot, fusion, wake-the-neighbors, toe-curling sex!

Good luck.

Dr. Bob