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I made a mistake
Jun 22, 2011

First i am a HIV+ homosexual male [bottom]. Ive been on Atripla for about a year and my VL is undetectable [has been since starting meds, literally dropped from 20k to undetectable in a month of taking the meds] and my CD4 count is 536. I ended up getting a bit too drunk last week with the guy im dating and we had unprotected sex; i check myself and there wasnt any pain or signs of tearing or anything like that. But i wanted to know what is the risk of transmission from a positive bottom to a negative top?

Response from Dr. Frascino

Hi.

The CDC's estimated per-act statistical risk for acquiring HIV from unprotected insertive anal sex with a partner confirmed to be virally enhanced (HIV positive) is 6.5 per 10,000 exposures. That you are on effective combination antiretroviral therapy that has driven your HIV plasma viral load to undetectable levels for a year would significantly decrease (but not completely eliminate) any chance of HIV transmission.

Have you disclosed your HIV-positive status to your buddy? If not, you need to. He will need HIV-antibody testing at both the three- and six-month marks.

Dr. Bob



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