Question
What about viral load blips and transmission risk to partners?
28 July 2016. Related: All topics, HIV transmission, Sero different couples.
I’ve been HIV positive for a little over 9 months and have been on effective treatment (ART) for coming up to eight months and was undectable after three months.
Since the publications of the Partner study results and others, I’ve found the courage to start having sexual relationships again.
I recently gave and received oral sex with a girl whose STD status I obviously cannot be certain of, our mouth health was good, and ejaculation did not occur.
I have however read that viral load load blips could occur from a recent vaccination / illness even with the continued adherence to medication. The week previous I had been unwell after receiving the Phenumoccoal and Hep A and B vaccinations, however had been feeling better for 3-4 days before the sexual encounter occured.
Given the chance of a viral blip, whilst likely to not be significantly high virologically, I am now worried I might have put the sexual partner under undue risk, and am worried I should now tell her about my concerns.
Answer
Hi
Thanks for your question and for letting us post it online for others to read.
It is good that you know about the PARTNER study and that you now feel more confident having a more active sex life again. HIV treatment is so effective at preventing transmission that you can relax about about any risk to your partner.
The PARTNER study reported zero HIV transmissions when couples had sex without condoms more than 58,000 times.
The study provides some data to answer your concern about low level blips. This is because blips were likely to happen in the study in-between viral load tests – and no transmissions occurred. Also, no transmission occurred when couples had another STI, which can blip viral load in a similar way to some vaccinations.
Even if a blip occurred in your situation it would not have put your partner at any risk of catching HIV, even if you were having penetrative sex without a condom.
Oral sex with low viral load and good oral health is also a zero risk, with or without blips. Although oral sex can be a way to catch HIV, this generally needs both very high viral load and poor oral health.