Question

As a trans man, can testosterone treatment increase my risk of becoming HIV positive?

22 August 2014. Related: All topics, HIV transmission, Transgender.

I’m a HIV negative trans guy, my partner is a positive guy. Could my testosterone therapy increase the risk of transmission?

I’ve been taking testosterone for over four years now, but have no plans to have lower surgery. Is my T doing anything to my existing body parts that could increase my risk HIV?

Answer

Answer: Simon Collins

Hi,

Thanks for your questions.

Testosterone treatment itself doesn’t mean you have to be at higher risk for HIV but it does cause a couple of biological changes that are related to risk. If you are aware about these it is easy to take care to make sure your risk is still low.

The first is that T is likely to decrease your natural lubrication (compared to before you were taking T). This makes it especially important to use plenty of lube. The second is that T reduces the thickness of the inside walls of the vagina which may make them more vulnerable to tissue damage from friction.

This makes it more important to use lube and condoms carefully this will protect you from HIV.

However, the background risk of HIV is also related to other factors. One of these include whether your partner is on treatment and whether he has an undetectable viral load.

Although there is increasing evidence that the risk of transmission is dramatically reduced when someone has an undetectable viral load, transmission is still possible. If you decide not to use condoms, the effect of the T would makes it even more important to be careful with using enough lube.

This i-Base guide on testing and transmission has more information about different risks.

This is the section on condom use.

This is a report about transmission risk with undetectable viral load.