Doctor: I am a HIV+ gay male in meds, who has been undetectable for over 2 years. Currently dating a negative male, we always use protection for anal sex, but a couple of days ago realize that the condom broke while I was being the top and finishing the act inside of him. Doctor, Could I have infected him, even thought I am undetectable? This only happens once, What are the changes that he is + now? Does he have the risk to get infected by dating a positive undetectable male? Thanks

Hi,

Receptive anal sex (condom failure) does place your buddy at risk for STDs, including HIV. That you are currently on effective combination antiretroviral therapy, which has driven your HIV plasma viral load to undetectable levels over the past two years, significantly decreases the risk of HIV transmission, but it does not completely eliminate it. If you are still within the 72-hour post-exposure window, a course of PEP (post-exposure prophylaxis) could be considered. I would suggest you and your potential future Mr. Right read the information in the archives related to magnetic couples. There are a number of harm-reduction techniques that may be useful in decreasing the potential risk of HIV transmission resulting from accidental exposure, such as a condom failure.

Your partner should get HIV tested at both the three- and six-month marks.

Good luck to you both.

Dr. Bob