Prep Mandatory? + Strange Results

[spouse]

Hi group - Has been a bumpy ride in my life over the past few weeks.

I'm a male who has been with a female partner (now married) for 2 years from the Western World but living in Africa. When going through the steps to gain residency in my home country for her the requirement of a medical test was put in place, and she was diagnosed + to shock and dismay. We followed up after the initial diagnosis for a second test at a different facility and the results were conclusive where she was positive and I was not. This has caused lots of confusion with us - and further followed up with CD4, Creatinine, and Virile Load tests. We also started her on Atripla immediately, and held off on sending in the document to the immigration officials until we got her numbers along with a follow up CD4 count to show that there was indeed improvement.

The tests came back today with surprising results, CD4 - 507, VL Undetectable. Obviously great news, but more confusion with us. I should add her sister (same father, different mother) has been living positive for her entire life without a single day of medication (now 21 years old).

So, two questions, if they make sense:
1) Is it mandatory that I would need to be on a Prep like Truvada for us to engage in sexual activity due to her results? Obviously we would like to do the right thing, we are just wondering what the correct course of action could be.

2) Is her results normal? As I said, we have quite the confusion with her sister/and now her results here. Or is it a situation that it is lying dormant and then at some stage going to switch on. We agreed she should continue with taking the medication regardless - The country we are in here provide the medication cost free only if your CD4 count is <350 - so we are footing the bills, which is fine, that is not an issue for us at present. I can't seem to find much information on a situation like this - hoping someone can chime in and provide some insight.

Thank you for your time and this resource.

[zach]

1. no, prep is not mandatory... it is recommended in a magnetic relationship, but it's a personal choice

2. i'm not sure i understand why you think her results are abnormal?

she was diagnosed positive, began medication, her cd4 is 507, her viral load is currently UD

you tested negative

Nothing about what you have said jumps out as abnormal, accept the lab results and move forward from there.

[spouse]

Thanks for the reply Zach.

Sorry, to clarify on the "abnormal" comment - We are just wondering how common is it to someone who has been diagnosed to have an undetectable VL without taking any medication before hand.

We're definitely on the path forward!

[zach]

We are just wondering how common is it to someone who has been diagnosed to have an undetectable VL without taking any medication before hand.

not rare... not common either. it's a good thing!

were the numbers normal? best answer, the one that is hard for noobs to hear... it doesn't matter, it is what it.

questions that are anything like "how long have i been infected" are impossible to answer, and even knowing the answer has no bearing

she's taken the first big steps getting diagnosed and into treatment... the next challenge you'll both face, acceptance, is a tougher process

looking backwards with questions, that won't lead you forward