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Likelihood of converting from HIV- to HIV+ given my partner's HIV + status
Sep 28, 2000

I am HIV-, but currently living with my lover who is HIV+. We always have sex with condoms, but he is always the top. What are the possibilities that I'll contract the virus if we continue to practice safe sex? Are there any studies indicating the percent of conversion from neg. to pos. when the HIV- one is having safe sex with an HIV+ person(in my case my lover). If this question has been asked and answered before, please let me know so that I can read the answer. My lover is very anxious to know, he is very worried for me (of course, I'm worried too).

Response from Mr. Kull

Try reading through my response to Condom Failure. That response summarizes some studies about the effectiveness of condoms among mixed-status/serodiscordant couples. The bottom line is that when condoms are used correctly, every time, and there is no breakage or slippage, HIV transmission doesn't happen.

It seems that the most common reason for infection happening in mixed-status gay couples is not using a condom at all for anal sex.

This doesn't mean that condoms don't fail and that your risk is eliminated. You need to figure out what feels safe and unsafe for you. One way to reduce your risk for infection is to have your partner not ejaculate when he is inside of you. You greatly reduce the risk of rupturing the condom and getting semen inside of your rectum.

Some recent studies suggest that a lower viral load decreases the risk of transmission to a negative partner. Read through Serodiscordant gay couple anal sex. Talk to your partner about this. Taking medication is a complicated decision, but it may be a good prevention tool.

You should also be aware of options for taking medications yourself if you feel like you experience a significant exposure with your partner. Post-exposure prophylaxis (PEP) is a still experimental, but promising, antiviral medication regimen for people to take within 72 hours of a high risk exposure. It is believed that it could reduce your chance for actually becoming infected. You should consult an HIV specialist in advance to learn about your options in an emergency.

I recommend that you also consult Robert Remien's Mixed-HIV-Status Couples Forum for more support in your situation. Read through some of the recently answered questions in that forum to get a better idea of some of the issues people face.

Best --

RMK



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