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Undetectable but had unprotected anal sex 4 times with a guy

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Proparask:
Hey there!👋

I was diagnosed on November 2022 so it's been half a year now living with the virus. I found it soon and got treatment as soon a possible. I was undetectable with 0 viral load on January, 3 weeks after i started ART treatment wirh Bictarvy. Last week i tested undetectable for the second time so the doctors gave me the okay officially now for unprotected sex.

Of course i use condom for other stds but one time last week i had receiving oral sex with a guy and had an ejaculation inside. After that i read some research articles online about men with undetectable blood status but detectable viral load on their semen while on ART drugs. I was feeling like i killed someone or like i was obligated to tell him my status so he can take pep as soon as possible. But then read a bit more and saw that still those cases are an exception to the rule and most of the times that happens when someone has at the same time another infection, most of the times with another STI, and at the same time oral sex is the less risky sex practise.

I wanted to share it with you to see if my fear was valid and what is actually true. Also, can i test my semen viral load as well as i do with my blood ❓️

Thank you all in advance for any answeres to my concerns!🙂

Jim Allen:
Hiya,

Moved your post here as your post is mostly regarding HIV prevention.


--- Quote ---Also, can i test my semen viral load as well as i do with my blood ❓️
--- End quote ---

Why? No need, and it would be excessive.

With treatment (HAART/ART), once you have achieved an undetectable viral load (below 200 copies) for at least six months, you can't sexually pass on HIV.

Minor blips and trace HIV RNA even with successful treatment will happen and remain present in tissue and fluids from things like viral shedding, including defective copies from the reservoirs etc., detecting this is just not a transmission issue.

At this stage, there are nearly 25+ years of evidence on TaSP (Treatment as Prevention), both through observational data and controlled studies, that consistently has confirmed its effectiveness leading to the Swiss statement 15 years ago and, in recent years, the refined consensus statement (U=U)

You are not going to be worlds first.


--- Quote ---Last week i tested undetectable for the second time so the doctors gave me the okay officially now for unprotected sex.
--- End quote ---

 :o You would never hear a doctor saying that here. Sounds like a compensation claim waiting to happen concerning STIs and pregnancy.

At best, they might say that with a suppressed viral load you can't pass on HIV sexually.


--- Quote ---I was undetectable with 0 viral load on January
--- End quote ---

0 copies detected, it would not mean that your viral load is 0; it was just below the threshold needed for detection, so usually, this would be less than 20 or 50 copies, but in some regions of the world, the threshold in labs for detection can be higher.


--- Quote ---detectable viral load on their semen while on ART drugs
--- End quote ---

I'll go one step further and tell you that some research suggests that up to 10% of men on HAART sometimes will have a detectable HIV RNA in their semen.

However, detectable HIV RNA when doing viral load testing on semen doesn't mean complete copies or complete HIV copies at levels that will transmit; these "blips" also haven't resulted in passing on HIV in any of the long-term studies or observations.

The waiting six months before saying you can't sexually pass on HIV treatment after having the first suppressed viral load (below 200 copies) in the blood with HAART is to ensure treatment is working and allow the genital fluids that closely follow the blood levels drop off sufficiently to levels that will not pass on HIV. 


--- Quote ---I was feeling like i killed someone or like i was obligated to tell him my status so he can take pep as soon as possible.
--- End quote ---

He doesn't need PEP over giving you a blowjob.

Proparask:
Hello there!

I have posted two more times on this forum.
I am a student living in Greece. I have tested positive on November 2022 and i found it really fast (the infection was on October 2022)
I am undetectable 6 months now, under antiretroviral therapy with Bictarvy and i am very responsible on taking the pills consistently.
I have had two one night stands with two different guys this month and while douching 30m - 1hour before sex, i saw a really small amount of blood (1mm pink color when focusing and zooming in) on the wet wipes coming from my anus. The first time it was because of shaving with a hair clipper and the other time it was just because of douching.
I am using condoms as an extra precausion when it come to penetrated sex but am getting paranoid after oral sex (fellatio or anilingus) because almost nonody uses condoms for this kind of contact.
So after those two times i had sex and i received anal licking from the guys, i am really stressed if there was a small amount of blood from shaving or douching that came in their mouth and maybe it has led to an infection even tho i am undetectable (U=U).
So my question is: Is it possible for the person that licks down there, if he has a small abrasion in his mouth and receives in his mouth even a really small amount of blood from a tiny scratch on the anus, that he can be infected with hiv, even if the person that receives the licking is undetectable and under ART drugs for at least 6 months ? (i have tested two times in a row as undetectable).
Please let me know as i am getting paranoid and really stressed.

Thank you in advance for any response!

Jim Allen:
Hiya.

Read your post three times, you didn't pass on HIV by receiving a blowjob or anilingus.


--- Quote ---I am using condoms as an extra precausion when it come to penetrated sex

--- End quote ---

It's not needed to prevent passing on HIV.

However, if you are comfortable using condoms than keep doing. see, although condoms are far less effective at preventing easier to aquire STIs such as, STIs passed on through skin contact in areas not covered by condoms, they still do offer some level of STI risk reduction

Proparask:
I don't really know if this is a prevention or mental health issue and i would really use
your advice!
I am 8 months with the virus now and 6 months undetectable with Bictarvy.
I am going out and having sex with a friend that knows my status. Since i told
him he reacted nicely about it and the last 4 times we had unprotected anal sex.
I am the bottom and one time there was a small amount of blood coming out
after penetration, maybe because of shaving 2 hours before.
He is trusting me and i am very responsible. I am taking the pills every day
at a specific time and i have two alarms to be sure. When i go out i take them
with me. But sometimes i have nightmares that i did not take the pill and one day
two weeks ago i woke up 4 in the morning banging my head to remember if i
took the pill or not. In two days i am going to the hospital and they will test
for the fourth time my viral load but it takes forever for the results to be annouced.
Last time it took 3 months. When 3 weeks after our first unprotected contact
have passed i will pay for him to go and take a test for hiv, so i can see in practice
that U=U is not only a theory but is real.

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