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MY BOYFRIEND HAS HIV
Oct 31, 2012

we have just found out that my boyfriend has hiv. we have slept together, but i am currently on a tablet the doctor prescibed me to take everyday for a month. I want to stay with him and make this work but im worried about my health and myself getting the disease. i love him dearly and will do anything to be with him. how does one put their parents at ease about the situation as well?

Response from Mr. Cordova

Hi there:

I am sorry to hear about your boyfriends recent diagnosis. He is lucky to have someone like you in his life. You obviously love him very much. In response to your specific questions....

Q: Why haven't I seroconverted?

A: HIV transmission does not occur every time you engage in unprotected penetrative sex. Also, the risk is much lower for the insertive or top partner. Don't forget, the window period for a conclusive test result is 90 days. An antibody test 90 days from the last time the two of you engaged in unprotected penetrative sex would provide your true status.

Q: In light of the HPTN 052 study, is it really all that necessary for me to use a condom when his viral load drops down to undetectable levels?

A: While that study provided a lot of important information about the efficacy of HIV treatment as prevention, it's important to understand that most of the participants in that study were heterosexual. Only slightly more than 2% of the total amount of participants were male/male couples. The risk of HIV transmission with penile-vaginal sex is lower than with penile-anal sex. So while the study showed a drastic decrease in the likelihood of transmission, the risk was not eliminated. This would be especially true for anyone engaging in anal sex.

Q: Would starting on HAART now, burn out his drug options later?

A: Current guidelines and recommendations show more providers opting to start individuals on HAART even with a CD4 count greater than 500. Starting on a regimen earlier in his infection would not "burn out" his options for later. Not adhering to taking his medication as prescribed however can cause resistance. Resistance can eliminate whole classes of drugs for people, and limit their regimen options. Whatever regimen he is on, it will be important for him to take his medication exactly as prescribed by his doctor. Anything you can do to help with that will be to his benefit.

Q: Should I consider PrEP?

A: I think PrEP could be a very viable option for you in this situation. Based on what you have told me so far, it sounds like even though you want to be as safe as possible, you also enjoy not having to use a condom with your boyfriend. Given that scenario, PrEP might be just what you need to offer that extra layer of protection. I would speak with his doctor about the possibility of starting on PrEP. Some insurance companies will cover the cost. Many will not. The out-of-pocket cost is pretty high, and out of reach for most of us. If insurance won't cover the cost, you may be able to look into joining a study on the efficacy of PrEP. In a study, the medication is typically provided free of charge.

You might find these two posts helpful as well:

1:Serodiscordant relationship and unprotected anal sex

2:Unprotected sex, serodiscordant monogamous couple

If he hasn't already found it, I would point your boyfriend in the direction of our Just Diagnosed section here on TheBody.com. It will be a helpful resource for him during this time.

When you feel that it is appropriate, I would suggest that the two of you sit down and look through our forum on Mixed-HIV-Status Couples. It's likely that every question you will have has already been asked by magnetic (+/-)couples just like you and your boyfriend.

Last but not least, keep in mind that being diagnosed with HIV is a traumatic life event. He will be going through just about every emotion in the book, this includes being angry. He may try to push you away. Don't be afraid to give him the space that he needs, just make sure he knows that you are there, and are available when he is ready to talk. Empathy and compassion will be the greatest tools at your disposal. Good luck. Be sure to write back in! Keep me posted on how things are going, and be sure you are tested for HIV every three months.

In health,

Richard



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