Neg male poz female undetectable viral load - condomless vaginal?

[whaleshark]

Have read the forum, pored over Partner Study, Swiss Statement etc. but would love to get more info on how others approach protection/risk.

Basics:
Me:  neg male, no STIs other than oral herpes (1-2 outbreaks per year).
Girlfriend:  poz female, viral load undetectable for 8 years.  Strictly follows her ART schedule.  Had cervical lesions removed (HPV) before.  Otherwise in great health and clean.

Situation:  I'd like to have occasional vaginal sex without a condom (that is, not every single time).  At this stage, she won't consider it. 

Question for other couples:
--Is there any real consensus from science on whether there is risk from unprotected vaginal intercourse with neg male poz female?
--Do you engage in unprotected vaginal intercourse?
--How did you discuss the risks and decide on whether it was ok?
--How can I bring this up with my partner?

Her doctor will not counsel any unprotected sexual intercourse. 

Part of her concern may be that she is proof it only takes one exposure - very limited # of sexual partners in her history and even then very very few unprotected encounters.

Not willing to risk the relationship to make it a big deal, but would enjoy unprotected intercourse with her.

Thank you all very much in advance. 

Will add the lovey-dovey stuff below in a reply - it's a wonderful relationship, and other than the need for using protection, her status is a non-issue for me other than I am in awe of her strength, courage and grace in how she lives with HIV.  She's my hero.

[Wade]

Hi Whaleshark ,and welcome to the Forums
I'm glad you found us and you are in a good place in your relationship.
Sounds like you have done your homework reading and pouring over studies,
but there is nothing like advice from others in the same boat.

There are quite a few serodiscordant couples on the boards here and I'm sure they will be weighing in with their own experiences, advice and challenges.
Good luck to you and your Hero !

Best, Wade

[heretolearn]

I found out I was positive when I was pregnant and married. So I read lots of studies and decided that I would do what my negative husband wanted when it came to condom use. There is a risk involved but sense he is my life-long mate and would just as soon take the positive journey with me, he does not want to use them. So we don't. We just don't have sex if I ever have a herpes outbreak. He didn't catch hiv before I was in medication so he thinks he most likely won't catch it. When I was diagnosed he said he wished he had it too so I wouldn't have to do it alone but I don't him he was crazy.
They are calling the risk of contracting hiv from an undetectable partner "negligible" these days. It is just a decision you will have to make together. My doctors told my husband he did not qualify for PrEP because I am adherent and undetectable. I don't think it is something to be taken lightly but I will say that we believe the risk is less with someone who is undetectable than with someone with an unknown status.

[Waltern]

Hi welcome, we in the same boat man, my partner has been positive over 10 years now, for the past three years i stopped using condoms cos i wanted to be affectionately without any boundaries, i was advised that pep is like overkilling since there is no recorded case where transmission occurred in a serodiscordant couple where one is got undetectable viral load, though its a decision to be taken by both of you, it is also in our advantage as an insertive partner. Its scary at first but when time goes you get to used testing negative everytime you decide to, i would say the risk is near to zero if your partner is and has been undetectable for over six months. Good luck and enjoy life as it presents, you can inbox me if need any further clarity.

[tyranossaurusrex]

here is a thread (quite recently, from april 2016) from an user who was negative, followed the statement of the partner study and the swiss study, had sex without condom, and got infected by her undetectable partner: http://forums.poz.com/index.php?topic=62387.msg701653#msg701653

[Waltern]

Even in partner study about 11 people became hiv positive but none of this infections  were phylogenetically linked transmissions. There are lot of missing informationon on that thread to prove it correct, Was genetically (genetic test) proven that the transmission occured from the primary boyfriend who has been undetectable? Was the test done before seroconversion? Until we answer those questions there will be doubts on the authenticity about transmission from undetectable partner

[Waltern]

ZERO!!! No linked HIV transmissions in PARTNER study after couples had sex 58000 times without a condoms. Research tests are able to compare different viruses from different people.  I agree with heretolearn, "the risk is less with someone undetectable than someone with unknown status.

[whaleshark]

Thank you all very much for your input.  All very helpful.

My girlfriend and I share very open, honest and caring communication.  A bit more for us to consider here.  I am learning a bit more online about how her HPV may impact transmission.  I probably already have HPV given how prevalent it is, but no tests exist, and I've never had any visible symptoms.

She's my hero, and having the relationship is far more important to me than condomless sex.  I would like to share that level of intimacy with her, but appreciate she does not want to infect me.

I've spent the better part of my adult life in the SF Bay Area, where HIV is an open and relatively well-understood part of life.  To me it is just another chronic condition that can be managed if therapy is made available and followed, and transmission can be easily avoided with availability of and adherence to proper precaution.  Not to minimize the seriousness of it; trying to remember that she's doing everything right to take care of herself and myself, and as that continues, HIV does not need to be a problem in our relationship.

Unfortunately in her part of the world, where I now live, old stigmas still exist, so her disclosing to me was very challenging for her.  She disclosed her status with incredible courage and grace - I was impressed then and I am still so impressed.  Took incredible guts to do that, and she did it before there was any possible transmission risk.

She accepts the chronic conditions I have, which carry stigmas as well, but cannot be transmitted from person to person.  Can't thank her enough for that, especially as my ex wife did not accept them and would not try to understand them, due to stigma.

I guess we're lucky to have each other, because we can understand each other so well. I'm incredibly happy in this magnetic relationship!!!

[CaveyUK]

She is undetectable. There is zero HIV transmission risk.

But as a caveat, there is still a risk of other STI's if either of you are not monogamous, and of course there is a pregnancy risk unless she uses some form of contraception.