Q and A

Question

How long will my wife need to take ARVs?

Hi doctor.
I tested HIV positive 3 yrs ago together with my wife. I took septrin for 2months before I stopped. From the onset I took CD4 count and it was 465; the 2nd was 543; the 3rd was 650; the 4th was 770; the 5th was 861 and the last one I took two weeks ago was 940. The same case my wife who now has 897 up from 360.

She is on ARVS because we are trying to concieve. My question is, what are the risks of my wife stopping taking the ARVS? Or for how long will she take the Arvs?

We have not been using any protection. What are the risks?

Answer

Firstly, I would like to confirm that we are HIV positive treatment advocates, and not doctors.

You have asked a number of questions so I will try and answer them one a time.

Your first question is what the risk to your wife if she stops taking her ARVs. Without treatment your wife’s CD4 count is likely to drop back to where it was before she started and to continue dropping. If her CD4 count drops to 200 cells or less, she may be at risk of developing opportunistic infections. These are infections such as pneumonia, which a person can get when they have a weak immune system.

Your second question is how long she will need to take the ARVs. Both European and WHO (World Health Organisation) treatment guidelines recommend starting when you have a CD4 count of 350. This is close to what your wife’s CD4 count was when she started. The aim of treatment is to maintain a good CD4 count (above 350) and to reduce the amount of virus in your body. This is referred to as having an undetectable viral load. Your wife will therefore need to continue taking the treatment for life. Having a good CD4 count and an undetectable viral load will enable her to stay well for many years.

Your third question was regarding what the risks are if you don’t use protection as you are trying to conceive. Many HIV positive choose not to use condoms for protection. The main risk involved is if one of you has resistance to 1 or more HIV treatments. This is another reason why your wife should not stop taking ARVs. She will therefore need to take her medication exactly as advised and not miss any doses. This is to prevent her from becoming resistant to her current medication and risk passing on the resistance on to you. For more information on resistance, please follow this link to our guide.

Another risk of not using condoms is getting STIs [Sexually transmitted infections]. A further issue could be being re-infected with another strain of HIV. The HIV which one person has is not always the same type(strain) as another person. However, without knowing the full details around your circumstances, it is not possible to know if this will be an issue for you.

Generally, if neither of you have resistance or STIs, then there should be not problem with having unprotected sex. The key thing to note though is that if your wife does become pregnant, the recommendation is to use condoms. This is in order to minimise the risk of transmitting HIV to the baby. For more information on HIV, pregnancy and women’s health please follow this link to our guide

Best wishes

36 comments

  1. Simon Collins

    Hi Nomvula

    As your questions starts a new subject, please see this link for the answer:
    http://i-base.info/qa/10168

  2. nomvula

    my name is nomvula and i’m HIV positive. my problem is that i was using an ARVs that i’ve used to collect in pretoria clinic and now they are nearly finished before then i’ve transfered my file from Daveyton to Pretoria couse i was moving to pta location. Now i came back to Daveyton and they said i can’t get another transfer and i don’t have enough money to go and collect my ARVs in Pretoria. Even here in Daveyton they refuse to give me a meds without file. I don’t know what to do please help me or must i go to another clinic and start afresh from the tests?

  3. Simon Collins

    Hi Samuel

    I have answered your question here:
    http://i-base.info/qa/10135

  4. Samuel

    Hi, recently I found out that my wife had HIV, way before I meet her 6 years ago, and now we have two kids. She was not feeling good being weak so I took her to our doctor. Thats when I found out all those years I knew nothing about her status. I did a rapid test and it was negative but the reason she was weak was because she did not take her medication for a month. Should I be stressing.

  5. Robin Jakob

    Hi Alex,

    It is good to hear that your wife has tested negative. It is common for one partner in a relationship to test positive and the other to test negative.

    HIV is actually a difficult virus to catch. The fact you have been on treatment for so long also greatly reduces the risk of transmission.

    A recent study called PARTNER had to do with the risk of transmission during sex without a condom. This is when one partner is negative and one positive. The study showed that the risk of transmission taking place when the positive partners viral load is undetectable is very low. In over 44,500 occasions when the participants had unprotected sex there where no HIV transmissions. This does not mean that transmission is not going to happen, just that the risk is very low.

    You can find more information on the PARTNER study here: http://i-base.info/htb/24904

    And more information on risks of transmission here: http://i-base.info/guides/testing/risk-hiv-status

  6. alex

    Hi my wife tested negative after being married for 4 years and not using protection. Will she remain negative? I’ve been on ARVs for 8 tears.

  7. Rebecca McDowall

    Hi Khanyisile,
    Although it must be very difficult it is going that you know your daughter’s HIV status and that she is able to get the medicine she needs to keep her well. It is important that you get tested so that you can get ARVs too if you need them. It is normal to be frightened but it’s important to know your status so that if you are HIV positive you can get the treatment you need to allow you to live a long and healthy life and see your daughter grow up.

  8. khanyisile

    my 2 years child tested positive and she started the arvs.now im scared of going and test

  9. Rebecca McDowall

    Hi Arnold,
    Taking your meds twice in one day shouldn’t cause any problems although you might experience more side effects than normal.

  10. Arnold

    Hi I want to know what will happen if I took my ARV twice in a day. I forgot that I took my meds already then I took it again which is supposedly I took my ARV meds 1 in a day. Thanks for the reply.

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