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Author Topic: Confused about having sex with someone on Prep and people with HIV unprotected.  (Read 863 times)

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Offline jm1953

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  • Posts: 285
If a person is on Prep, HIV Negative, can he/she have unprotected sex with someone with AIDS and not get it, or is protection still needed?

I've been told if you are undetectable you can have sex with both HIV- and HIV+ folks and not pass your strain on.  True or not?

If two committed partners with AIDS in a closed relationship both are undetectable, is there no chance they may pass their virus onto their partner without using protection?

Heard so many versions of what you should or shouldn't my head is spinning.  I thought the forum would have better insight.

Kind of afraid to have sex having AIDS because I feel like I should be the responsible party.

Anyone know the real scoop on all this.

Much appreciated,

JM

Positive 29 years. Diagnosed 10/1987.  Current CD 4: 720: Viral load: almost 100.  Current drug regimen, Tivicay, Emtriva, Endurant, Wellbutrin, Clonazepam, Uloric, Losartan Potassium,Allegra, Ambien, Testosterone, Nandrolone, Vicodin, Benedryl, Aspirin, lots of vitamin supplements.

Offline leatherman

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  • Google and HIV meds are Your Friends
wow. i see your confusion, so here goes:

AIDS is basically when an HIV+ person has <200 tcells and/or an opportunistic infection. Quite often they also have a very high viral load. AIDS is also called Advanced HIV Disease to help people understand that it isn't a separate thing from HIV. It's an HIV+ condition at its worst! Most often someone living with AIDS but who has become undetectable also has an immune system that has recovered over 200 cd4, which would then mean they were no longer living with AIDS but HIV.

Don't get stuck on the word AIDS. Although someone diagnosed with AIDS is always classified as an AIDS case for tracking/funding purposes, by the time someone has reached UD and/or gotten tcells >200, we usually don't talk about them as an AIDS patient anymore; but just an HIV+ patient.

an hiv+ person who has remained UD (which is the sign of successful treatment because we can't do much to help with the cd4 count besides a person's genetic ability to recover after HIV is treated) for probably about 2 yrs. has a near zero chance of transmitting HIV

if both partners are HIV+ and both on successful treatment, they don't have enough viral load to transmit HIV much less their own HAART treatments act as both PEP and PrEP protecting them both. However any partner who is not UD, clearly is failing therapy and opens up the chance of being infected with a partner's HIV which may have different mutations (or may not ;))

so here are the answers for you

If a person is on Prep, HIV Negative, can he/she have unprotected sex with someone with AIDS and not get it, or is protection still needed?
while PrEP is very good, it's not perfect and someone with AIDS (who is NOT undetectable) could infect that person using PrEP. However a person with AIDS who was UD (a rarity) probably wouldn't.

I've been told if you are undetectable you can have sex with both HIV- and HIV+ folks and not pass your strain on.  True or not?
maybe, probably; but the HIV+ person would have had to be UD for at least 2 yrs. At least thats what the science is beginning to tell us. I'm sure that they will nail down the exact length of time to UD eventually.

If two committed partners with AIDS in a closed relationship both are undetectable, is there no chance they may pass their virus onto their partner without using protection?
both undetectable for at least 2 yrs probably aren't transmitting HIV. Remember don't stuck on that AIDS word.

Kind of afraid to have sex having AIDS because I feel like I should be the responsible party.
why do you still consider yourself to have AIDS? Is your cd4 > 200? (then you're not living with AIDS) Do you have any opportunistic infections? (if not, then you're not living with AIDS) are you undetectable? (then you're probably not living with AIDS either, or you are still in the process of recovering from AIDS)

of course, being the person knowing that they are hiv+ YOU are the responsible party - for yourself and somewhat for your partner. Your partner is also responsible for their own status too, outside of your responsibility

hope that helps somewhat with all those crazy scenarios ;)
leatherman (aka mIkIE)

So we put our hands up like the ceiling can’t hold us
"Can't Hold Us" - Macklemore & Ryan Lewis

chart from 1992-2015 Reyataz/Norvir/Truvada

Offline bocker3

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  • Posts: 3,675
  • You gotta enjoy life......
However any partner who is not UD, clearly is failing therapy

This may or may not be true.  Some people take longer than others to achieve that UD status and it is NOT due to failing therapy.  I started meds in Dec. 2005 and did not have my first UD result until Jul 2007!  yes -- a year and a half later.  I am still on the same meds today and have had nary a blip since reaching UD, while my CD4's have rebounded from a low of 288 to almost 1,000 on my last lab visit.
Additionally, folks can experience "blips" - low levels of detectable virus - and it doesn't, necessarily, indicate failing therapy.

I'm simply throwing out these distinctions because so many people have lots of angst over the length of time it can take for some to achieve UD or when a blip occurs after being UD. I think it's important for folks to know that these things are not always about failing therapy.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2015 969/28% <20

Offline phoenix

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  • Posts: 53
So a person UD for a year and a half with a cd4 count below 200 is "recovering" from aids and unlikely to infect?
A positive attitude may not solve all your problems but it will annoy enough people to make it worthwhile.                              The point of the journey is not to arrive.

Offline harleymc

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  • Posts: 314
Undetectable is the important thing defining safety.
The cd4 count  and/or the history of AIDS defining infections/ cancers is irrelevant.

Offline next2u

  • Member
  • Posts: 1,793
I was wondering something similar. I've been in a relationship with an HIV negative partner over 2 years. I've been undetectable almost 5 years and he is still negative. I spoke with my dr today (my bf was with me) and we broached the subject. My ID dr didn't seem to concerned about it and he might as well have used air quotations when he said "I'm supposed to tell you to have safe/safer sex." We have some other medical issues that we are working through but we are considering forgoing condoms in a year or so and with permission from my ID dr. We currently use condoms for penetrative anal sex. My bf was recently diagnosed with hep c but it appears to be in remission. Once it is cured and an acceptable period has passed we will broach the conversation again with my dr. Any thoughts?

Edited to change from over 5 years to almost 5 years :)
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5
sept14 cd4 990; vl ud; cd4% *
jun15 cd4 1152; vl ud; cd4% *
july15 -> SWITCHED TO STRIBILD

Offline mecch

  • Member
  • Posts: 12,857
  • red pill? or blue pill?
I was wondering something similar. I've been in a relationship with an HIV negative partner over 2 years. I've been undetectable almost 5 years and he is still negative. I spoke with my dr today (my bf was with me) and we broached the subject. My ID dr didn't seem to concerned about it and he might as well have used air quotations when he said "I'm supposed to tell you to have safe/safer sex." We have some other medical issues that we are working through but we are considering forgoing condoms in a year or so and with permission from my ID dr. We currently use condoms for penetrative anal sex. My bf was recently diagnosed with hep c but it appears to be in remission. Once it is cured and an acceptable period has passed we will broach the conversation again with my dr. Any thoughts?

Edited to change from over 5 years to almost 5 years :)

Something has been lost in communication between you and the doctor or between you and us. 

Hep C does not go into "remission".  Someone has it, or someone self cures.  Or someone takes the treatment is cured by the treatment. 

Also, after a cure, the person loses antibodies and could get reinfected, eventually.   

« Last Edit: July 15, 2015, 05:06:14 AM by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline bocker3

  • Member
  • Posts: 3,675
  • You gotta enjoy life......
Actually, some doctors do use the term "remission" because they feel that one can't know for sure, at least early on, if all the virus has been removed.  There are some who feel that some virus can be "hiding" and reemerge.  I think this is especially true for folks who seemed to get rid of the virus on their own.
Of course, I don't know how you ever really know, because any "reemergence of Hep C could just as likely be a new infection.

At any rate -- it might make sense to ask your doctor about this term and what he/she means by it -- rather than dismissing it out right due to an online opinion.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
Sep05 T=350/25% VL98,559
Nov05 288/18%  47,564
Current Labs
May2015 969/28% <20

Offline next2u

  • Member
  • Posts: 1,793
yo, sorry about that. my dr didn't use the term remission. i did. ;). the first set of labs revealed a hep c viral load that was somewhere around 50,000. that was 6-9 months ago. about a month ago his hep c viral load was like 50. both of his drs were fairly optimistic. especially with harvoni as the back up plan. they said it looks like he may clear the virus without meds. my body did the same (albeit i was much younger and prettier when that happened  :P)

umm, i guess ill start my own thread with a clearer question and some other stuff. thanks for the response :)~

~d
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5
sept14 cd4 990; vl ud; cd4% *
jun15 cd4 1152; vl ud; cd4% *
july15 -> SWITCHED TO STRIBILD

 


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