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Bareback sex with a Positive Partner Mar 15, I'm a 25 year old man with a 24 year old HIV positive life-partner who is a bottom receiver. His CD-4 count is very high and his Viral load is undetectable and has been for several months. We have had protected sex for a year now. I am wondering if anyone is in a similar situation. We are looking into the risks of unprotected sex with me as a negative top and he as a positive bottom.

Clearly the risk of infection would be greater if the roles were reversed. Can anyone who might be in a similar relationship please let me know their opinions? Frascino Hi, You're wondering if anyone is in a similar situation? Yes, of course there are!

Many folks are now involved in magnetic coupling, including yours truly. We have an entire chapter in the archives devoted to magnetic couples. Regarding HIV-transmission risk, there is no doubt that when the positively charged partner uses effective combination antiretroviral therapy that drives his or her HIV plasma viral load to undetectable levels for a considerable period of time, the risk of HIV transmission is significantly decreased.

However, it's important to note that despite this, the transmission risk is not completely eliminated. You and your virally enhanced Mr. Right should read through the information in the archives of this forum devoted to magnetic couples, HIV sexual transmission, HIV sexual prevention and related topics. I'll post below a small sample of what can be found in the archives. My very strong advice is that you continue to protect your negative HIV status by continuing to use condoms for penetrative sex.

I have several friends who are in magnetic partnerships and relationships and they have unprotected sex, all of them, and none of these couples have infected the negative partner, however all of the infected partners are medicated. I have one friend who has been positive for 5 years, has had three negative lovers, he is a top and had unprotected sex with all of them, none of them were infected.

I know one couple who has been together for 13 years, the negative partner is still negative, they use condoms and medication, but even they have admitted to having unprotected sex many times. I myself had a negative lover who, by his own decision, refused condoms, he is still negative, I am on medication and I bottom. My question is then, if my doctor tells me it's still possible to infect someone while I am on medication, and so does thebody. How possible is it if your viral load is undetectable?

The books tell me it's still very likely, life tells me otherwise. Sincerely confused Response from Dr. Frascino Hello, Books that indicate HIV transmission is "very likely" between magnetic couples, even when the positively charged person is on effective combination antiretroviral therapy cART that has driven his HIV plasma viral load to undetectable levels, are overestimating the risk considerably.

Here's what we know. Effective cART that drives the viral load to undetectable levels significantly decreases any chance of HIV transmission; however, it does not eliminate the risk completely. That's the critical point. Decreased risk is not no risk! You can read much more about this in the archives of this forum. I'll post below a small sample of what can be found there. Well I guess it's more an assumption than a certainty. I don't know any study which strictly confirms what you're saying.

Instead there's a study ongoing which should give an answer to this question. In the meantime telling that treatment does not eliminate the risk for transmission is wrong since we still don't know it precisely. It would be more correct to say that until the trial is completed and the results confirms that HAART is able in reducing to a negligible level or even eliminate the risk, traditional safe sex methods are still recommended.

Frascino Hello, Sorry, I disagree. We have documented cases of mother-to-child transmission, despite the mother having an undetectable viral load. There are also case reports of male-to-female transmission via unprotected vaginal sex, despite the male having an undetectable viral load. How often this happens we don't know, but we do know it occurs. Until we know more, the only logical advice is to continue using condoms for all penetrative sex. We'll keep you posted as this story evolves.

Hope you had an excellent and I pray for you that will be full of good health. Hope you can answer my question. Frascino Hi, Undetectable means the HIV plasma viral load is below the lower limit of detection for the particular test assay that is being used.

Early viral load tests could only test down to 10, copies. Newer tests were able to test down to copies of the virus per milliliter of plasma. We now have ultra-ultrasensitive assays available in some research laboratories that can test down to a single copy per ml! HIV still exists inside cells in the blood, lymph nodes and other body compartments. Your blood has fewer copies than the lowest number detected by this test.

So it's less than 20 copies per milliliter. I hope that helps clear up any confusion. While we are on the topic of "undetectable" viral loads, I should take the opportunity to clear up common misunderstandings about this terminology: Undetectable does not mean cured! Undetectable does not mean noninfectious that you cannot transmit the virus to others! We have cases documenting HIV transmission from a man with an undetectable viral load to his HIV-negative wife via unprotected vaginal sex.

There are also cases of mother-to-child transmission, despite the mother having an undetectable viral load. Undetectable does not mean the virus cannot be detected anywhere in the body. Despite having an undetectable viral load in the blood plasma , the virus would still be readily detectable in other tissues and body compartments. Effective combination antiretroviral therapy does not kill the virus! Rather it merely suppresses viral replication.

Consequently, if someone with an undetectable viral load on combination antiretroviral therapy stops taking his drugs, the virus will soon start reproducing again and the viral load will skyrocket to levels near to where the viral load was before treatment was begun. So maybe the old Swiss should be a bit more mindful about how non-medical people interpret such statements. How to I donate - you are a star and provide light where there is darkness a bit biblical but true Thanks A 'less confused' London Boy Response from Dr.

That's an incorrect interpretation of the data they presented and does not accurately characterize their conclusions. Read through my comments on the Swiss Report in the archives of this forum I'll repost a sample below for a better understanding of the report and what it means. I'm delighted you have found this forum "enlightening! The report stated that HIV is not likely to be passed on when the positive partner fully adhered to a potent HIV regimen, had undetectable viral load for at least six months, and did not have any other sexually transmitted infection STI during that time, even despite sex without condoms.

What ensued after its publication has been tumultuous community discourse and opinion pieces worldwide. Some have denounced the Swiss government as being irresponsible. Others responded with "no comment". Few others, like Project Inform, invited this as a way to discuss issues faced by people living with and affected by HIV. Seven panelists attempted to clarify the persistent questions that have lingered ever since.

Project Inform attended this session of about , which expands our earlier coverage of this topic. The outcry over the Swiss report stems from the perception that they were saying that people who take effective HIV drugs can stop having safer sex or abandon their condom use without infecting their partners.

The panelists were clear: Some have criticized other aspects of the report, arguing it failed to address other important issues, such men who have sex with men. The possible implications for others living with HIV are about as diverse as the outcry has been. Project Inform believes the report and the conversations it has spurred can help inform these discussions for a wide range of people living with HIV.

The main issues brought up by the Swiss Report are broadly outlined below. Provide Accurate Information The report provides a good deal of applicable data, much buried beneath the vocal backlash. Physicians, community health professionals, and others who interact with HIV-positive people and their partners can and must provide information clearly and accurately. The basic model of fully informed decision-making that has defined Project Inform's approach to HIV treatment decisions is just as applicable to this situation.

Use This as a Tool We should encourage sophisticated discussions of the issues facing mixed status couples. After nearly three decades of the epidemic, a great deal is known about how HIV is and is not passed.

Each partner, along with their doctors, can be encouraged to discuss these issues. These data, when discussed alongside a person's needs for true sexual intimacy, can lead to fuller and more honest discussions between sexual partners. There's a great degree of disagreement over the effect this report might have on sexual practices and condom use. Lacking any real world data, people are left mostly to conjecture. One of the panelists shared findings from an anonymous survey he helped administer to people with HIV.

He stated the report was widely well received by people with HIV, and did not have a marked influence on sexual practices. Interestingly, many did report feeling more able to honestly discuss their sexual practices with their doctors after the report. Some of the panelists feared the Swiss report would lead to less condom use.

One audience member asserted his belief that the report said that condom use was not needed when people were on suppressive HAART. Others felt that the report was likely to increase adherence to both treatment and safer sex practices. Get Regular Health Care One undeniable take-home message from the Swiss report is the critical importance of having accurate medical information to make informed decisions. Vast inequalities in access to things like viral load tests and STI screening must be accounted for in settings worldwide.

Some panelists felt that these differences render the report largely meaningless to most people with HIV.

Video by theme:

Sex workers talk about their most expensive service: companionship.



London female for bareback sex

Bareback sex with a Positive Partner Mar 15, I'm a 25 year old man with a 24 year old HIV positive life-partner who is a bottom receiver. His CD-4 count is very high and his Viral load is undetectable and has been for several months. We have had protected sex for a year now. I am wondering if anyone is in a similar situation. We are looking into the risks of unprotected sex with me as a negative top and he as a positive bottom.

Clearly the risk of infection would be greater if the roles were reversed. Can anyone who might be in a similar relationship please let me know their opinions? Frascino Hi, You're wondering if anyone is in a similar situation? Yes, of course there are! Many folks are now involved in magnetic coupling, including yours truly. We have an entire chapter in the archives devoted to magnetic couples. Regarding HIV-transmission risk, there is no doubt that when the positively charged partner uses effective combination antiretroviral therapy that drives his or her HIV plasma viral load to undetectable levels for a considerable period of time, the risk of HIV transmission is significantly decreased.

However, it's important to note that despite this, the transmission risk is not completely eliminated. You and your virally enhanced Mr. Right should read through the information in the archives of this forum devoted to magnetic couples, HIV sexual transmission, HIV sexual prevention and related topics.

I'll post below a small sample of what can be found in the archives. My very strong advice is that you continue to protect your negative HIV status by continuing to use condoms for penetrative sex. I have several friends who are in magnetic partnerships and relationships and they have unprotected sex, all of them, and none of these couples have infected the negative partner, however all of the infected partners are medicated.

I have one friend who has been positive for 5 years, has had three negative lovers, he is a top and had unprotected sex with all of them, none of them were infected. I know one couple who has been together for 13 years, the negative partner is still negative, they use condoms and medication, but even they have admitted to having unprotected sex many times. I myself had a negative lover who, by his own decision, refused condoms, he is still negative, I am on medication and I bottom.

My question is then, if my doctor tells me it's still possible to infect someone while I am on medication, and so does thebody. How possible is it if your viral load is undetectable? The books tell me it's still very likely, life tells me otherwise.

Sincerely confused Response from Dr. Frascino Hello, Books that indicate HIV transmission is "very likely" between magnetic couples, even when the positively charged person is on effective combination antiretroviral therapy cART that has driven his HIV plasma viral load to undetectable levels, are overestimating the risk considerably.

Here's what we know. Effective cART that drives the viral load to undetectable levels significantly decreases any chance of HIV transmission; however, it does not eliminate the risk completely. That's the critical point. Decreased risk is not no risk! You can read much more about this in the archives of this forum.

I'll post below a small sample of what can be found there. Well I guess it's more an assumption than a certainty.

I don't know any study which strictly confirms what you're saying. Instead there's a study ongoing which should give an answer to this question. In the meantime telling that treatment does not eliminate the risk for transmission is wrong since we still don't know it precisely. It would be more correct to say that until the trial is completed and the results confirms that HAART is able in reducing to a negligible level or even eliminate the risk, traditional safe sex methods are still recommended.

Frascino Hello, Sorry, I disagree. We have documented cases of mother-to-child transmission, despite the mother having an undetectable viral load. There are also case reports of male-to-female transmission via unprotected vaginal sex, despite the male having an undetectable viral load.

How often this happens we don't know, but we do know it occurs. Until we know more, the only logical advice is to continue using condoms for all penetrative sex.

We'll keep you posted as this story evolves. Hope you had an excellent and I pray for you that will be full of good health.

Hope you can answer my question. Frascino Hi, Undetectable means the HIV plasma viral load is below the lower limit of detection for the particular test assay that is being used. Early viral load tests could only test down to 10, copies.

Newer tests were able to test down to copies of the virus per milliliter of plasma. We now have ultra-ultrasensitive assays available in some research laboratories that can test down to a single copy per ml!

HIV still exists inside cells in the blood, lymph nodes and other body compartments. Your blood has fewer copies than the lowest number detected by this test. So it's less than 20 copies per milliliter. I hope that helps clear up any confusion. While we are on the topic of "undetectable" viral loads, I should take the opportunity to clear up common misunderstandings about this terminology: Undetectable does not mean cured! Undetectable does not mean noninfectious that you cannot transmit the virus to others!

We have cases documenting HIV transmission from a man with an undetectable viral load to his HIV-negative wife via unprotected vaginal sex. There are also cases of mother-to-child transmission, despite the mother having an undetectable viral load. Undetectable does not mean the virus cannot be detected anywhere in the body. Despite having an undetectable viral load in the blood plasma , the virus would still be readily detectable in other tissues and body compartments.

Effective combination antiretroviral therapy does not kill the virus! Rather it merely suppresses viral replication. Consequently, if someone with an undetectable viral load on combination antiretroviral therapy stops taking his drugs, the virus will soon start reproducing again and the viral load will skyrocket to levels near to where the viral load was before treatment was begun.

So maybe the old Swiss should be a bit more mindful about how non-medical people interpret such statements. How to I donate - you are a star and provide light where there is darkness a bit biblical but true Thanks A 'less confused' London Boy Response from Dr.

That's an incorrect interpretation of the data they presented and does not accurately characterize their conclusions. Read through my comments on the Swiss Report in the archives of this forum I'll repost a sample below for a better understanding of the report and what it means. I'm delighted you have found this forum "enlightening!

The report stated that HIV is not likely to be passed on when the positive partner fully adhered to a potent HIV regimen, had undetectable viral load for at least six months, and did not have any other sexually transmitted infection STI during that time, even despite sex without condoms.

What ensued after its publication has been tumultuous community discourse and opinion pieces worldwide. Some have denounced the Swiss government as being irresponsible. Others responded with "no comment". Few others, like Project Inform, invited this as a way to discuss issues faced by people living with and affected by HIV. Seven panelists attempted to clarify the persistent questions that have lingered ever since. Project Inform attended this session of about , which expands our earlier coverage of this topic.

The outcry over the Swiss report stems from the perception that they were saying that people who take effective HIV drugs can stop having safer sex or abandon their condom use without infecting their partners. The panelists were clear: Some have criticized other aspects of the report, arguing it failed to address other important issues, such men who have sex with men.

The possible implications for others living with HIV are about as diverse as the outcry has been. Project Inform believes the report and the conversations it has spurred can help inform these discussions for a wide range of people living with HIV.

The main issues brought up by the Swiss Report are broadly outlined below. Provide Accurate Information The report provides a good deal of applicable data, much buried beneath the vocal backlash. Physicians, community health professionals, and others who interact with HIV-positive people and their partners can and must provide information clearly and accurately.

The basic model of fully informed decision-making that has defined Project Inform's approach to HIV treatment decisions is just as applicable to this situation.

Use This as a Tool We should encourage sophisticated discussions of the issues facing mixed status couples. After nearly three decades of the epidemic, a great deal is known about how HIV is and is not passed.

Each partner, along with their doctors, can be encouraged to discuss these issues. These data, when discussed alongside a person's needs for true sexual intimacy, can lead to fuller and more honest discussions between sexual partners. There's a great degree of disagreement over the effect this report might have on sexual practices and condom use.

Lacking any real world data, people are left mostly to conjecture. One of the panelists shared findings from an anonymous survey he helped administer to people with HIV. He stated the report was widely well received by people with HIV, and did not have a marked influence on sexual practices.

Interestingly, many did report feeling more able to honestly discuss their sexual practices with their doctors after the report.

Some of the panelists feared the Swiss report would lead to less condom use. One audience member asserted his belief that the report said that condom use was not needed when people were on suppressive HAART. Others felt that the report was likely to increase adherence to both treatment and safer sex practices. Get Regular Health Care One undeniable take-home message from the Swiss report is the critical importance of having accurate medical information to make informed decisions.

Vast inequalities in access to things like viral load tests and STI screening must be accounted for in settings worldwide. Some panelists felt that these differences render the report largely meaningless to most people with HIV.

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3 Comments

  1. And that is enough for some people to be fundamentally against it. I myself had a negative lover who, by his own decision, refused condoms, he is still negative, I am on medication and I bottom. This is shown in the following quotes:

  2. Hope you can answer my question. The better the data are, the more confidence people can have in their choices. Should every man who engages in barebacking undergo psychoanalysis to be able to manage drives more effectively?

  3. I don't know any study which strictly confirms what you're saying. There are times when a few condom-free strokes don't seem like they'd hurt anyone and we were both down so… I've given in to requests of full-on bare sex to orgasm on occasion, depending how hot and convincing the invitation was and how turned on I already was. But to acknowledge that we want raw sex entails a big risk in itself, because that doesn't fit in with the image of the good, responsible gay man who dutifully practices safe sex.

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