Hi - I'm a positive 70 yr old male. Undetectable for 6 years and CD4 in the 900's. While having protected sex today with my 70 yr old wife, the condom slipped off inside her and I ejactulated inside her. I assume not in the condom as after she fished it out of her vagina, there was little semen inside the condom. My normal amount of semen is somewhat small (doesn't normally even fill 1/2 of the condom reservoir).

My question is - should my wife start Atripla (I have extra pills) or just wait for her annual HIV test in 3 months?

I understand the risk of unprotected transmission of HIV from a positive male to female is slightly under 1% and a male with an undetectable VL is much less.

Thanks for all your good work and advice.

CL

Hi You are correct that HIV transmission from someone who has an undetectable viral load is decreased by up to 96%. My recommendation would be to get tested in 3-4 weeks and then again at 90 days. My husband is negative and he gets tested about every 6 months. You can talk to your healthcare provider about PreP, the use of Truvada has been approved for use for someone is HIV negative to prevent transmission.

Be well, Shannon