condomless sex with undetectable HIV+

[lior0911]

Hey all
we're a gay couple who involves in a monogamous relationship.  my HIV+ undetectable BF (who's being like that for 6 years and has a strict discipline with meds)  and me are thinking about getting rid of the condom. even his doctor said that the risk of transmitting the virus is so low that we could do that.
i have read about the PARTNER study and the meantime conclusions are quite awesome.
but still, once we do that, we want to be sure we're getting the right decision plus other's experience.
what i'm asking is to hear about that kind of experience from POZ\NEG couples (preferably gays).
besides, what do you think about that?

thanks and health to all

[CaveyUK]

It is a completely personal decision. What may be right and work well for one couple won't for others.

There is no right or wrong decision regarding it.

Sounds like you are fairly clued up about the subject. Really is just a case of discussing with your BF and deciding what risk levels you are comfortable with.

[gap]

Hey Lior,
hello from Italy!
I'm very new here like you, negative and in a gay relationship with a positive guy since almost 2 years.
Like your BF, he's undetectable but since today we've always (Well..almost always) had protected sex.

Did you finally decide for getting rid of the condom?

[tednlou2]

I recently made a post about this, as my partner and I decided to ditch condoms.  The evidence seems pretty clear that the chances of infection are very low-- even zero. 

I follow Dr. Gallant, who is well versed on all the studies.  He has been asked whether semen and anal fluids could still be infectious, despite being UD in blood.  He says if you're UD in the blood then you're either going to be UD in semen and anal fluids or it will be too low to transmit.  And there are studies showing infections from STI's or something else don't raise the risk of transmission.  And has said there's evidence that blips wouldn't cause an issue either. 

So, this is something that couples just have to consider-- you can't say it could never happen, but so far no evidence exists that has happened with an UD vl.  Once someone has been on meds for 6 months or so and vl tested, the poz partner will know whether they are failing a regimen due to pre-existing resistance.  Of course, someone could not be adherent and fail.  It is very unusual to fail with good adherence. 

I have decided I want my vl checked at least every 3 months, just to be sure.  And that is in line with guidelines anyway, until you've been UD for 2 years and then it can be moved to every 6 months.  I still have some anxiety that transmission may happen, despite all the studies.... I will be one of those weird cases or something.  But, no "weird" cases have happened yet.  Topping with ejaculation inside is the most anxiety producing.  I'm not talking not being able to sleep or anything, but just some worry.  I can't help but think all that semen in a place known to be the greatest transmission vector won't have some viable virus that could infect.  But so far, there is no evidence that it has happened. 

Gallant even says it is overkill and a waste of money for the neg partner to be on PrEP, unless it just gives someone more peace of mind and they need that peace of mind or if they aren't sure their partner is being adherent. 

[gap]

Thank you for your answer tednlou2.
In Italy PrEP is not approved yet, but seems it will be soon. Anyway I don't think I will start it, as long as my partner is UD: for sure it can help manking sex almost 100% sure, but I don't know if I really want to start taking pills everyday that can have some longtime side effects on my body.

This can be a risk, in the same way there is a small risk of being infected with a UD partner.
But, for sure, this is only my opinion