Anonymous
Hello, thanks in advance for your help and the important service you are providing.

After a lot of research and living with this for years, I am fairly confident in what I know, though I want to take away some lingering doubts, since I can only find indirect answers in regard to the following situations.

Considering:
* Man with HIV but takes ART medication without fail for 5 years (hereafter refered to as P)
* P has been been undetectable since the first year
* P has a HIV-negative female partner (hereafter refered to as N)

Then what is the risk of transmission in the following sexual activities:

1a: In a post (https://helpline.aidsvancouver.org/post/wounds-on-lips-close-contact-chance-of-hiv-transmission-10345090), you state “the act of kissing (Direct contact) when two individuals have superficial wounds would be considered a Low Risk activity. Low risk activities warrant HIV testing as this is the only way to be sure if transmission has occurred.” My question: is this also true if P = undetectable, and the kissing is deep and wild?

1b: Deep kissing, while N has active lesions of mouth herpes and P has bleeding gums

2a: Deep anal licking by N of P, while P has small wound on anus
2b: Deep anal licking by N of P, while P has small wound on anus and N has bleeding gums
2c: Deep anal licking by N of P, with some insertion of rectal secretions
2d: Deep anal licking by N of P, with N having active lesions of mouth herpes

3a: N drinking urine from P
3b: N getting urine from P on/in anus/vagina

4a: P having an orgasm in vagina of N, while N is on her period
4b: P having an orgasm in vagina of N, while N is bleeding vaginally because of other reasons than her period

5: Sharing a non-cleaned dildo vaginally or analy

6a: Deep penatration of the throat of N with penis of P
6b: Deep penatration of the throat of N with penis of P, while N has soar (infected) throat glands

7: What other (sexual or non-sexual) scenarios exist whereas P can infect N?

Thank you for your answers
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helpline-volunteer

Hi there,

 

Thank you for your inquiry. From what we gather from the question, you were asking about various sexual activities between a serodiscordant couple (one partner is HIV positive and the other is not). From the information given, this scenario is deemed to be No risk (Transmission of HIV is not possible in the given scenario). This is assuming that P has been adhering to his ART medication.

 

The best resource for this question is the PARTNER study. It followed over 800 serodiscordant couples, where the HIV positive partner was on virally suppressive ART (1). The researchers found that there was zero transmission of HIV among the partners even though there were 58,500 instances of unprotected sex reported (2). If you are HIV positive and undetectable you are not able to transmit the virus through sexual intercourse and therefore undetectable equals untransmittable (3).

Regards,

AIDS Vancouver Helpline/Online, Rashell

 

If you are satisfied with the Helpline service, please consider donating.


References: 
1.) PARTNER Study

2.) Understanding the PARTNER Study

3.) U=U

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