Question
Is my partner still safe if my viral load is 100?
26 March 2022. Related: Adherence, All topics, Sero different couples.
Hi, I have been on HIV meds for almost two years and have been undetectable, well had less than 50 copies until my last test which showed 100 copies which I’m guessing may be because of a “blip” because I have found myself missing a dose for a day or taking my meds a little late.
My concern now however, is that I have had unprotected sex with my partner and I had sex at the time I should be taking meds, meaning I took my pill two hours later. I had been religiously taking my meds at the same time for two months making sure that I don’t miss at all. So I believe my partner is still safe right?
Answer
Hi, how are you doing?
Yes your partner is still fine. U=U still applies to any viral load below 200.
Missing occasional doses or being late by a few hours should not be a cause for a blip.
Blips can be caused by other infections e.g., COVID, recent vaccines, randomly, or the most common reason being a lab error. Have you had your test confirmed with a second?
Josh.
Hi Sophie, PrEP is recommend to those at substantial risk of HIV transmission. In a case of where the partner is undetectable and U=U applies there is no risk and PrEP is not required. However if this partner does not take their medication daily or their viral load is not robustly undetectable this is when PrEP would be recommended.
In this case. PrEP is only a recommendation and is not a requirement. It is the choice of the person taking PrEP to decide if they want to take it. More information about PrEP can be found here: https://i-base.info/guides/prep
Hi, Josh
live in South Africa
Hi khan,
It is great news that you are planning a family with your wife,
Your viral load being undetectable is fantastic. One benefit of treatment is U=U which means there is no risk of HIV transmission to your wife. PrEP is not essential but can be used as an additional safety.
The information your doctor provided is inaccurate. Your viral load is undetectable and so missing PrEP would not have put your wife at risk.
Hope everything goes well with family planning.
Hello, is PREP essential for natural conception while her husband is on ART and achieved long term viral suppression?
My viral load is undetectable for 2 years and my wife wanted a baby so we started unprotected sex and doctor recomended PREP for my wife before 7 days of sex and she will continue till the first month of pregnancy.
Doctor told me clearly if she misses PREP she will be infected even if ur viral load is zero.
One day she had a UTI infection and missed PREP for more than 4 days. In these days i didn’t have sex with her but the doctor told me she is at risk.
So please speak plainly, i am very tense and worried about her.
I am from Pakistan
Hi Sophie, can I ask where you are based? Some countries still hold medical practises that are not up to date in the management of HIV and this could be a potential reason.
A person is considered undetectable when their viral load is below 200. This means that they cannot pass on HIV via sex and this is supported by U=U: https://i-base.info/u-equals-u/
While relying on U=U there is no need for any more precautions. PrEP is not needed and a condom is only required if protected against other sexually transmitted diseases. U=U is supported by over 20 years of research, the most prominent being the PARTNER study. This sought to identify transmission between both straight and gay couples when viral load was less than 200. Over these two studies, participants had sex 135000 times and there was no instance of transmission.
Why do some doctors recommend PREP for a negative partner even though the positive partner is undetectable? Is is extra precautions? Or has there ever been a case where the virus was passed to negative partner even though it was infected able on the other
Hi Khan, you cannot transmit HIV. If your viral load is undetectable (any viral load below 200 is considered as such) you cannot pass on HIV via sex. This is explained by U=U which you can read about here: https://i-base.info/u-equals-u/ There is no reason for your wife to be on PrEP and using condoms while you are on medication and undetectable.
Salam
My viral load zero and my doctor prescribe PREP for my wife we did sex and she got pregnant
After pregnancy doctor says to.my wife u must to take prep for a month and told me u have to use condnm for sex
But she miss 3 days prep while i didnt sex with her at time so i told to my doctor he say ur wife and ur baby is at risk.
He says if ur viral load is zero u can still transmitt the virus so plz speak plainly my is at risk or not give me detail answer thanks
Hi Mercy, given the vaccine was a month prior, your result will not be affected by this. As you have been consistent the most likely explanations are lab error or this was a transient blip, meaning it will recover on the next test.
While the increase may appear a lot, it is still less than 3-times your original viral load which rarely indicates need for concern.
Hi, I haven’t had a second test done yet, but have been consistent with my meds not missing a single dose
Speaking of vaccine causing a blip, I had my last test done a month after taking a second dose of Pfizer