Will PEP reduce the risk of infecting my negative partner?
I am a HIV positive gay man and my partner is negative.
I take my meds and my viral load is undetectable. My partner and I always use condoms. I still worry that I could infect my partner.
Realistically, how safe is my partner? Is sex with me risky for him? (He is active, I am passive). Also, can PEP helps to prevent my partner from being infected?
There are many couples (both gay and straight) who are in a similar situation as you. Sero-different couples (where one is partner positive and the other is negative) can have a good and healthy relationship for many years. There are many factors on how HIV is transmitted and you can find all the information at this link
Currently there is no cure or vaccination for HIV, even though there are many researches and trials that are pursuing this subject matter. These trials can take many years before the data is collected and analysed. The duration of the trial depends on the findings – at times the trial runs shorter than expected and at times it takes longer. We do not know how long these trials will take before they are publish.
The results from studies showing the dramatic impact on reducing risk of transmission when the positive partner is undetectable have mainly been from heterosexual couple who have low rates of anal sex.
In general, the risk to your partner will already be dramatically reduced compared to if you were not in treatment, but there is little data to say how low this risk goes.
It may go down very close to zero, but future studies are hoping to answer this question. Sexual transmission is still quite difficult, and being on treatment makes this even more so. So these recent studies are particularly important for people who have a negative partner. If you are continuing to use condoms – always a good idea – then you can relax about the odd time when a condom may break or slip off.
The actual risk will relate to other factors. Insertive sex is generally a lower risk than receptive sex. Your treatment is likely to have reduced the viral load in the tissue in your anus and the related mucous there. If you partner is circumcised, then this will also make HIV slightly more difficult for him to catch as the insertive partner.
So while no-one will ever be able to say the risk is zero (you can not prove a negative) it would probably be very hard for him to catch HIV from you even if this was something to set out to do. It is very unlikely that your partner will catch HIV while your viral load is undetectable especially if you continue using condoms.
PEP (post exposure prophylaxis) is a term used for taking HIV drugs after a possible exposure to reduce the risk of infection. PEP usually involves taking a combination of three HIV drugs for one month and you also need to be aware of the side effects of these drugs. Please take a look at our link for Q&A section based on PEP.