Question

My VL is undetectable but I worry: my HIV-neg partner won’t use condoms.

5 July 2016. Related: All topics, HIV transmission, Sero different couples.

Answer

Answer: Simon Collins

Hi

Thanks for your question.

If is good that you worry about your partner, so discussing looking at transmission risk first is perhaps best.

If the risk of HIV is your only concern, then there is probably no risk to your partner. So long as your viral load is undetectable and you are good with adherence, HIV transmission doesn’t seem to occur.

In all the studies looking at this risk – especially the PARTNER study – no liked  transmission occur even after having sex wihtou condoms more that 35,000 times.

It might take a while for the implications of these results to be understood though. Especially if you have been caref to use condoms for many years.

Having an undetectable viral load makes the risk as close to zero as scientists will ever be able to proove.

This means if HIV is your only concern, you have a new freedom to enjoy sex without condoms – so long as this is your personal choice 0 and you are not worried about pregnancy or other STIs.

You do have to feel happy to do this though. My if your worry is only about HIV, hopefully this answer will help.

The second issue though is about you being happy. Both partners have to be happy that there are doing things by choice.

Sometimes HIV negative people don’t want to use condoms for all sorts of reasons. Sometimes this is for generally good reasons – including better sex but also to show support for you as being positive (ie lack of fear).

Sometimes the reasons are more self-centred – ie thier preference, or lazyness, or selfishness (for thier own better sex). Sometimes it can even be becasue they know they are already HIV positive themselves but in denial – a very weird but try situation.

So although the HIV risk is zero, you have to be happy with not using condoms. Having a a partner that doesn’t recognise and respect your feelings is not good for your own well-being.

Sorry for a long answer.