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hiv and immuno-suppressants like arava or remicade
Sep 7, 2006

hello. no one will answer my questions, i hope you will be so kind.

i am 42 male and have rheumatoid arthritis. i take the 2 immuno-suppressant drugs listed above. i am the partner of a man who has hiv who is on medications, has an undetectable viral load, and t-cells greater than 800.

as for anal sex, we will always use condoms. my questions are how contageous is a man with a virtual viral load of zero? am i more susceptible to hiv being on these medications? what about oral sex with a man who has an undetectable viral load?

his doctor says that he could not infect me as he has no presence of the virus. is that true?

many thanks. he and i are very concerned.

Response from Dr. Frascino

Hello,

1. There is a big difference between an undetectable plasma viral load and "virtual viral load of zero!" Even with an undetectable viral load, HIVers are still infectious and can transmit the virus. Yes, it's true, driving the plasma viral load to undetectable levels does decrease the risk of HIV transmission, but it does not completely eliminate it.

2. Your immunosuppressant medications do not increase your susceptibility to HIV.

3. Oral sex with or without a detectable viral load carries a very low risk for HIV transmission. Driving the plasma viral load to undetectable limits would further lower this already very low risk.

4. No, I don't agree that your partner categorically could not infect you simply because his plasma viral load is undetectable. Safer sexual practices are still imperative. I suggest you and your partner browse through the information in the safer sex forum archives related to magnetic couples and HIV transmission.

Stay safe. Stay well.

Dr. Bob



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