Question

After 4 months on ART my VL is undetectable, can we stop condoms?

23 November 2016. Related: All topics, CD4 and viral load, HIV transmission.

I have been undetectable for HIV and Hep B for four and a half months now and am consistently taking my meds daily without fail (Truvada and Issentress). My BF is impatient to try unprotected sex, however, I’ve seen some guidelines published in certain brochures which state that we should wait at least 6 months before attempting unprotected sex. What is the rationale for this 6-month period? Why not 3, 4 or 5 months? Have people been known to relapse from undetectable to detectable again before 6 months have elapsed? How much difference do a further six weeks make?

Answer

Answer: Lisa Thorley

Thanks for getting in touch.

ARVs first reduce a persons viral load in their blood.  It can though take longer to reduce the viral load (VL) in other parts of our bodies, for example the genital track. This is why some quidelines recommend that people wait 3-6 months before stopping condoms.

If you can wait a little longer, then this is what is suggested. However, as people get more used to how well an undetectable viral load protects against infection, these guidelines might also change.

Any risk will already have been dramatically reduced because your VL is undetectable. If you and your partner are ok with this, then this is up to you. It should though be a decision that is taken jointly.

There are no data to know the difference between waiting 1, 3 or 6 months. This is just different recommendations based on theoretical risk.