Q and A

Question

What are the risks to my HIV negative partner?

I’m a HIV+ man with an undetectable viral load and a 480 CD4 count. I have the herpes virus, but take aciclovir for it, so I don’t have any symptoms. I also have the wart virus.
My concern is that I had sex with a HIV- man. I was the bottom and the condom broke. We didn’t know this until he had come. What are the chances that I could have passed on my HIV to him?

Answer

It is good that you have an undetectable viral load as this reduces the likely risk to being very low. Also, not every contact leads to infection so there is a good chance he will be lucky.

Having said that though, unprotected anal sex is a high risk contact and I will advise your partner to contact the nearest HIV clinic for information about post exposure prophylaxis (PEP). This is where, after a potential risk, you can take a course of HIV treatment, usually one month, to protect against the possible risk of catching HIV.

In order for PEP to stand a chance of working, this needs to happen as soon as possible – ie the sooner the better – and current guidelines say no later than 48-72 hours after the contact.

More information on PEP in the UK is on this link at the THT site.

The recent Swiss guidelines suggested PEP may not offer any benefit for people with an undetectable viral load, but this may be complicated by herpes as those guidelines also stressed the importance of not having any other active STIs.