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New relationship with woman that has HIV (undetectable)

Question: 

Hello,

I am here for support as I have never been in a relationship or know of any one that has had HIV. I know that I love this person. But I don't want to go though the relationship with all these Questions. First about me that I have never been diagnosed with anything and have only had two sexual partners my whole life.
The Woman that I meet is from Colombia and she was diagnosed with HIV back in 2013. Since then has been "undetectable" for 3-4 years. What I know is that she has been on medicine since the start (2013) and has been told that she is able to have children (by Columbia doctors) (2019). She has had unprotected sex with her ex-partner and there was never contagion.

This will sound stupid and I know, I am sure someone else has ask this.

But is there any risk for me being with a undetectable HIV partner?
Eating food together (sharing),
open-mouth kissing
Contact between broken skin (wounds)
Oral sex
safe vaginal or anal sex or Unprotected Sex

If we do go ahead with relationship How often should I get tested?

Is there any help for traveler coming to Vancouver?

Thanks You

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking for advice about your serodiscordant relationship (one partner is HIV positive and the other is not).

The best resource for information about sex among serodiscordant couples is the PARTNER study (1). This study followed almost 900 serodiscordant couples, in which the HIV positive partner was taking effective HIV treatment. The researchers found that these couples had a total of 58,000 unprotected sexual encounters with their partner within the time frame of the study and there was ZERO transmission of HIV among partners. This enforces the point that a person living with HIV who has an undetectable viral load is not able to transmit the virus through sexual intercourse, and thus when HIV is undetectable it is untransmittable (2).

Another important point that you brought up is the ability for your partner to have children without passing on the virus to the child. When a woman living with HIV becomes pregnant it is extremely important that she has access to effective HIV treatment. If her viral load remains low throughout pregnancy then the chance of passing on the virus to the child is less than 1% (compared to 25% if she does not have access to HIV treatment) (3). Although there is a low risk associated without mother to child transmission of HIV women living with HIV are still able to become mothers to healthy babies.

Please note that HIV is not transmitted through social or casual contact, such as sharing dishes, sharing toilets, hugging, shaking hands, or kissing with no blood present (4). Refer to the HIV Transmission Equation to assess your risk for any activities you may pursue. In general, any time there is a bodily fluid present that could contain HIV (eg. blood, vaginal fluids, breast milk) and you are engaging in an activity (eg. unprotected vaginal sex) that may provide direct access to your bloodstream (eg. urethra, open cuts) there is a risk of acquiring HIV. If you plan on engaging in risky activities, it may be beneficial to start taking pre-exposure prophylaxis (PrEP) to help lower your chance of acquiring HIV.

Lastly, in terms of testing, it is recommended by many guidelines to get tested for HIV at least once a year if you are in a serodiscordant relationship (5). Open communication, support for your partner, and proper precautions (effective HIV treatment, PrEP, condoms, etc.) are all key to keep you both safe and to have a fulfilling relationship.

Recommendation: Refer to a physician for more information about PrEP.

Regards,

AIDS Vancouver Helpline/Online, Marie