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Help Please

Question: 

hi, i was sleeping with a man who hide his hiv from me. we had sex with condoms but also oral (both). when i found out and confronted he said he is on medication. i checked for hiv a month a go and came out clean but still very worried. i found out about it only today. please help. what are chances of me getting it and what should i do?

Answer: 

Hello and thank you for contacting the AIDS Vancouver Helpline

We understand that you would like an assessment of your risk of acquiring HIV from having protected sex (presumably vaginal or anal) and performing and receiving oral sex with a man who is HIV positive, and who claims to be on anti-retroviral medication.

Condom protected anal/vaginal sex and performing oral sex are both classified as Low Risk activities for transmission of HIV (receiving oral sex is a negligible risk). There is evidence that transmission occurs through these activities when certain conditions are met. Examples of conditions that might facilitated an HIV transmission include condom failure, or the existence of cuts or open sores in the mouth.

If your partner is truly on medication and has successfully suppressed his viral load to undetectable levels, then he cannot transmit HIV to you. With 20 years of evidence demonstrating that HIV treatment is highly effective in reducing the transmission of HIV, the evidence is now clear that people living with HIV with an undetectable viral load cannot transmit HIV sexually. Three large studies of sexual HIV transmission among thousands of couples, one partner of which was living with HIV and the other was not, were undertaken between 2007 and 2016. In those studies, there was not a single case of sexual transmission of HIV from a virally suppressed person living with HIV to their HIV-negative partner. (1)

To maintain an undetectable viral load, it is very important for a person living with HIV to stay on treatment and have regular viral load tests. Regular viral load testing helps people living with HIV and their health-care providers to monitor the success of a treatment regimen. (1)

Recommendation: Since you don't know for certain if your partner is undetectable, HIV testing at six weeks after your last low risk sexual contact with him is recommended. Fourth-generation HIV tests can detect HIV infection in 50% of people by 18 days after infection; 95% of people by 34 days after infection; and 99% of people by one and a half months after infection. Fourth-generation HIV tests have a sensitivity of about 99.9% (2)

Regards, AIDS Vancouver Helpline Volunteer, Dyson