Question

Is there a risk if we are both positive but my partners viral load is a bit high?

14 August 2020. Related: All topics, Resistance.

Hi. I am HIV positive and so is my partner. We are both on ARVs. My viral load is undetectable and his viral load is a bit high. We sometimes don’t use condoms. What is the risk on my side?

Answer

Answer: Simon Collins

Hi

Thanks for your question.

There are two issues here and they are both related to your partners viral load.

When you say this is high this sounds a bit more than just detectable, perhaps several thousand copies/mL or even higher. At this level your partner is likely to be developing drug resistance to some of his meds.

This means that when not using condoms there is a chance that you could catch his drug resistance. This could then make your own combination fail. Although it is difficult to say how how high the risk is, it is serious enough for you both to be using condoms.

The second issue is about your partners treatment.

Is this the first combination he has used and has the doctor talked about changing to new drugs? If the new combination gets viral load to undetectable again, you can stop using condoms.

How good is your partner at taking his meds. If he often misses doses it is important to try to find ways to make this better. Otherwise there is a risk that the next combination will also fail.