Q: I’m sorry if this is a very basic question. I’ve seen in the news and read about multiple cases of HIV positive people still having successful, happy relationships with other people. Is it inevitable that, regardless of the degree of protection taken, the HIV infection will be spread from one person to another?
A: Well, even if it is a basic question, don’t apologize! That’s why we’re here at BlackDoctor.org. It’s actually a very good question. As I have discussed in some of the other questions, people are living much longer lives. We have quite a few patients in their 70s and even some in their 80s who are doing quite well. Along with increased life expectancy, people want to know that they can have the same expectations for a high quality of life and good relationships with sexual and emotional intimacy.
Now, back to your questions…
The answer to your question is no, it is not inevitable that HIV infection will be spread to an uninfected partner. In fact, there are growing numbers of individuals who are living with an HIV-infected partner who remain un-infected for many years. So, what do people need to do to insure they protect their partner? Two things have the biggest impact.
1. First and foremost (you already know the answer), condoms are very effective in protecting against infection. They really do work when used correctly.
2. The second part of the equation is also important – the infected partner should be on an effective HIV regimen. In the last few months, I have attended a couple of major HIV research conferences. One of the most exciting findings is that HIV treatment is also excellent prevention. Studies have been done in couples where one is infected and on effective treatment and the other person is not infected. There were virtually no cases where the uninfected person became infected. These findings are especially important because the couples in these studies were often NOT using condoms (again, not that people should stop using them, but still)!
We learned several years ago, that in a situation where one partner is positive and the other is negative, the negative partner almost never got infected if the amount of virus in the infected partner was low (viral load less than 1000 copies).
What is the best way to get the amount of virus in the blood low? By treatment, of course. With an effective regimen, the amount of HIV in the blood should be undetectable.
Now listen up , because this is important – again, I am not telling you to have unprotected sex if you or your partner is on treatment and has an undetectable level of virus. Even though the study results look really good, there could be some problems. For example, a person could have undetectable levels of HIV in the blood as a result of effective treatment, but, if they have an infection like gonorrhea or Chlamydia or maybe even a yeast infection, there could be high amounts of HIV virus in the semen or vaginal fluids. So, undetectable virus in the blood doesn’t always guarantee there is not virus in the reproductive tract. Also, a person on HIV medicine may not transmit their HIV to their partner but they could transmit other infections such as hepatitis B, syphilis or hepatitis C.
Finally, someone could be on medicines but not taking them properly and maynot be totally suppressed. So the best protection is for the HIV infected partner to be on treatment as well as using condoms. For couples who want to have a baby, talk with your medical provider. There are ways for HIV-infected couples to have healthy children and protect their health as well.
So the light is Green for you to proceed to a happy, healthy relationship!
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