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Undectable
Apr 21, 2012

I am considering playing with a guy that is Undectable, and I only play bareback cause I am alergic to condoms (both latex and non-latex). What are my chances of contracting HIV from him since he is undectable?

Response from Dr. Wohl

No one knows for sure. The data we have about transmission and viral load still is mostly limited to heterosexuals. In studies of hetero couples where one is positive and the other negative, the risk of transmission from a partner whose virus was controlled was very very very low. We assume but are not sure that most of this sex was penile-vaginal and not anal.

Anal sex may carry more risk especially if rough. Similarly, the risk to the bottom is likely greater than the risk to the top partner. An STD in either partner can up the ante significantly for HIV acquisition.

If your partner is undetectable, and neither you or he have gonorrhea, chlamydia, syphilis or obvious herpes ulcers and you are top, risk is rather low. Otherwise, all bets are off.

Another option (in addition to the above measures) would be to take a medication daily to prevent HIV risk. Truvada has been found to provide some protection to high risk HIV- men who have sex with men. Those who tae the medication every day without fail had best results.

DW



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