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unsafe sex
Aug 1, 2013

My partner and I are both HIV positive, we both on medication and with undetectable viral load. My fear is, most of the times we do practice an unprotected sex, we just feel that we need each other in a natural way. Whats the risk? How do we get assisted on this, my partner feels nothing when using condoms please advise.

Response from Ms. Southall

Hi Although we know having an undetectable blood viral load can greatly reduce the risk of HIV transmission, it is unclear exactly what this risk is reduced to.

In the research conducted so far, there have been no recorded HIV transmissions among heterosexual couples where the HIV-positive partner is on treatment and their blood viral load is undetectable. However, this does not mean the risk through condomless sex is zero. All of the couples studied to date have also reported using condoms often. This makes it difficult to determine the risk of HIV transmission when no condom is used.

Although there have been no studies among gay men and other MSM, there has been one report of HIV transmission occurring between two men when the HIV-positive partner had an undetectable viral load.

Also, the risk of HIV transmission when the viral load is undetectable may not be the same for all types of sex. This risk may be higher for anal sex than for vaginal sex, particularly if the HIV-negative partner is the receptive partner (bottom) during anal sex. This is because receptive anal sex generally carries a higher baseline HIV risk than other types of sex.

There are ongoing studies following serodiscordant heterosexual and same-sex couples who are taking HIV treatment, have an undetectable viral load, and do not always use condoms. These studies will provide a better understanding of the risk of HIV transmission when the viral load is undetectable.

I know this answer is towards magnetic couples it does give somewhat of a clear picture with a couple who are both positive. The risk of transmission reduces by up to 96%. But the fear of reinfection or being infected with a form of HIV that is resistant to medications that you are not on will out perform the HIV that you have and possibly make your HIV medications not work.

Be well and stay safe, Shannon



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