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I am positive but wife is negative
Aug 31, 2011

Hi there, i was being tested Hiv positive in last year september. Had a CD4 count test and it shows 675 and after being very sexual active for months,my wife got pregnant. The baby and her was fine and cleared from HIV which i was so surprised. Can she have some kind of immunity to the virus? Anyway,i got herpes zoster last week and i am not yet on meds. Recently we had sex and the condom broke but i pulled straight away when i sensed something is not right. Was sure there was no ejaculation nor blood but is my condition with herpes zoster going to make the transmission any higher? My wife has been very healthy during the course of her pregancy but she has some persistent cough after 2 months giving birth. Is this just pure luck that my wife did not get infected and this time she will? Please help..thank you so much

Response from Dr. Frascino

Hello.

Your wife is indeed lucky she has not contracted the virus. Fortunately not every HIV exposure leads to HIV transmission. The CDC's estimated per-act statistical risk for acquiring HIV from unprotected receptive penile-vaginal sex with a partner confirmed to be HIV positive is 1 per 1,000 exposures.

Your recent bout of herpes zoster won't increase the HIV-transmission risk; however, because you are confirmed to be HIV infected and not yet on antiretroviral therapy, I would recommend a course of post-exposure prophylaxis (PEP) for the broken-condom accidental exposure if PEP can be started within 72 hours of the exposure. If not, your wife should have follow-up HIV-antibody testing at the three- and six-month marks to be certain she did not contract the virus.

I would encourage you both to read through the chapter in the archives of this forum devoted to magnetic couples. You may wish to consider some of the harm-reduction strategies discussed, such as (1) you beginning antiretroviral therapy to decrease the transmission risk during accidental exposures, such as condom failure; (2) having a starter pack of PEP for accidental exposures; and (3) PrEP: pre-exposure prophylaxis.

Good luck to you both.

Dr. Bob



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