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Serodiscordant couple
Nov 26, 2010

Hi Dr I am 45 years of age, HIV +ive and on ART for many years. My CD4 count is 800 and viral load undetectable ( below 50 copies) per test done about 3 months back. My girl friend is negative. We had sex 2 weeks back and condom tore off. Please advise the risk and future course of action for us.

Regards

Response from Dr. Frascino

Hi,

That you are on effective ART, which has driven your HIV plasma viral load to undetectable levels, would significantly decrease the risk of HIV transmission from this condom-failure incident; however, it does not completely eliminate the risk. PEP (post-exposure prophylaxis) may have been warranted if it could have been started right after (and no later than 72 hours after) the exposure. At this point your only option is for your girlfriend to get HIV tested at the three- and six-month marks. The statistical odds are all in her favor, but testing is still warranted.

I would also suggest you and your partner read through the information in the chapter in the archives of this forum dedicated to magnetic couples. There you will find a discussion of harm-reduction measures, including PrEP (pre-exposure prophylaxis) that you might wish to consider using.

Good luck.

Dr. Bob



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