HIV Risk with Bottoming for a POZ Top with Undetectable Viral Load

Discussion in 'The Healthy Penis' started by earllogjam, Jan 16, 2011.

  1. earllogjam

    Gold Member

    Joined:
    Aug 15, 2006
    Messages:
    5,027
    Likes Received:
    21
    I've asked this question to a few testing clinics and they give the stock answer that it hasn't been researched and that I should ALWAYS use protection.

    But doesn't it follow that if a POZ guy who is taking antiviral medication and has undetectable or zero HIV load in his system is less likely to infect another person even if he is the insertee in anal sex sans condom?
     
  2. bigandblond

    bigandblond Member

    Joined:
    Nov 22, 2010
    Messages:
    90
    Likes Received:
    0
    Gender:
    Male
    It does follow that but it's always best to be safe and not risk it
     
  3. B_thickjohnny

    B_thickjohnny New Member

    Joined:
    Aug 2, 2007
    Messages:
    2,874
    Likes Received:
    42
    Gender:
    Male
    Location:
    Atlanta GA
    Why take the chance? If you did, get tested!
     
  4. dude_007

    Gold Member

    Joined:
    Dec 28, 2010
    Messages:
    4,891
    Likes Received:
    28
    Gender:
    Male
    Location:
    California
    Probably less likely but less likely does not mean risk-free
     
  5. fnaslut

    fnaslut New Member

    Joined:
    Apr 13, 2008
    Messages:
    246
    Likes Received:
    0
    Gender:
    Male
    Why bother risking it?? There is no evidence. It makes sense what you are saying, but undetectable viral load doesn't mean non-infectious...ergo, use a condom
     
  6. jump_start

    jump_start Member

    Joined:
    Apr 28, 2010
    Messages:
    531
    Albums:
    1
    Likes Received:
    9
    Gender:
    Male
    Location:
    Colorado
    What I'm about to say is based on my opinion, not fact, so the information may or may not be true.

    I don't care if the POZ top has an undetectable viral load. The fact of the matter is that the HIV virus is STILL IN HIS SYSTEM. Regardless of the fact that he may not be detectable, he still has it, and in my opinion, he may (should) still be able to transmit it.

    It isn't worth the chance. Use a condom.
     
  7. MarkLondon

    Gold Member

    Joined:
    Jun 11, 2008
    Messages:
    1,986
    Albums:
    4
    Likes Received:
    16
    Gender:
    Male
    Location:
    London, UK
    Look, if you too were poz with an undectable load, then it might be worth indulging in.

    Undetectable does not mean zero load. It means low. It refers to blood, not semen. Your rectum is very vulnerable to hiv infection, far more so than any other sexual entry point.

    I remember celebrating undetectable viral load with a close friend in the late 90s and he died of immune-suppressed cancer in 2000. It was a great loss...
     
    #7 MarkLondon, Jan 16, 2011
    Last edited: Jan 16, 2011
  8. pepinogrande

    pepinogrande Well-Known Member

    Joined:
    Jul 24, 2009
    Messages:
    318
    Albums:
    1
    Likes Received:
    264
    Gender:
    Male
    Location:
    New Orleans / The Land of Big Cucumbers
    Herpes...even when undetectable can be spread; there are many other STDs that can be spread when undetectable; pos guys have usually had other STDs as well; the fact that he would like unsafe sex make him and you: higher at risk. Value your life !
     
  9. earllogjam

    Gold Member

    Joined:
    Aug 15, 2006
    Messages:
    5,027
    Likes Received:
    21
    Any doctors MD's in the house that can shed some expert information on this subject?
     
  10. houtx48

    Gold Member

    Joined:
    Sep 13, 2006
    Messages:
    7,095
    Likes Received:
    35
    Gender:
    Male
    there is one bullet in the cylinder, click, your turn.
     
  11. FuzzyKen

    FuzzyKen New Member

    Joined:
    Nov 10, 2006
    Messages:
    2,116
    Likes Received:
    6
    Gender:
    Male
    As time has progressed, we have learned more and more about the nature and characteristics of the HIV retrovirus. In the beginning people treated people known to them as HIV sero-positive very poorly.

    We now know that the main pathway of transmission is by pathway to the bloodstream.

    In any anal act the anal canal can and often does suffer what are called "microtears" which are very tiny tears in the lining. Considering that based on medical theory all it takes is one single live virus to penetrate the appropriate barriers and begin a really exciting life cycle. It needs a host and it has very specific requirements for not dying in the process of spreading from one host to another. If you take this fellow on an anal basis you are participating in the one act that has the greatest risk of transmission.

    Now, on the subject of "undetectable". What this means is that the viral level or "load" is below a level that can easily be spotted quickly. People misinterpret this to make it sound more safe than it really is. A person who was tested and was tested as undetectable was ONLY undetectable at the time the blood was drawn. A viral load and a CD4 count both can vary widely within a matter of days. Viral loads are variable and can bounce in and out of "undetectable" between tests.

    Between the two of you there are so many things you can do to get the guy off and see to it that he enjoys himself this is almost a non issue.

    The sad fact is that there are many sero-positive individuals who for reasons unknown tend to make excuses for and seem to want to participate in behavior that could subject other individuals to a life of doctors, medications, testing and constant monitoring so that they can have a moment's pleasure.

    This guy may be the hottest guy on the planet. The reality is that you will have no way to 100% know what the outcome of that encounter could be for quite a while.

    I think that if it were me that I would rather make an error on the side of safety than on the side of a moments pleasure to one guy.

    I vote with those who say that if this is an issue the sex is not worth it.

    By the way, during my single years I never discriminated against any individual because of their HIV status. I never had a problem in seeing that these guys had a good time and if a person had ideas about sharing the gift that keeps on giving then I simply would not agree to sex with them. I made it through a time when most men in my age group who were sexually active did not survive. I buried a total of 53 people I knew between friends and several relatives because of this retrovirus. It got to a point that I was attending several funerals per month.

    My friend, people are still dying of complications from HIV infection. There are still immune systems collapsing.

    Have you ever seen a death from PML? How about a death from lymphoma? How about a person going blind from opportunistic eye infections? Then there were the few that decided that they would collect wart viruses. A couple of those guys had warts growing on top of warts to where entire sections of their bodies were hard like armor plate. My friend this is still taking place, but it is not taking place in big numbers any more.

    In HIV treatment there are men who insist that they can do anything they want and insist on burning the candle at both ends. As the immune system begins to collapse because of the load of numerous viral conditions including hepatitis combined with HIV, combined with other things the MD's treating these people have to resort to what they call "kitchen sinking" this means that they take a toxic brew of drugs that is so strong that the drugs themselves over time kill the person. Even this approach eventually wears out.

    The one thing that the HIV retrovirus is very good at is mutating. It imprints and changes itself into a form that the drugs must be changed in order to maintain low viral levels.

    Get real here. . . .you're risking your life for a few minutes of pleasure.
     
    #11 FuzzyKen, Jan 16, 2011
    Last edited: Jan 17, 2011
  12. Big_Red

    Big_Red Active Member

    Joined:
    Oct 5, 2007
    Messages:
    298
    Albums:
    1
    Likes Received:
    38
    Gender:
    Male
    Location:
    Great White North
    It depends upon the strength of your immune system, how rough the sex is and if he cums inside. The last factor is especially important in determining whether you contract the virus or not. But in general, the limited scientific study done on this one puts your chances at about 20% on average. Too bad that "20%" was never really defined. Does it mean 1 chance in 5 sex acts? 20% over the course of a year? 20% random chance at any time? We'll never know until more study is done... which will be never. Until that time comes, like someone else here already said, anal receptive sex with an HIV positive is no different than playing Russian roulette. Do you feel lucky?
     
  13. unhappybigguy

    unhappybigguy Member

    Joined:
    May 22, 2007
    Messages:
    32
    Albums:
    1
    Likes Received:
    98
    Gender:
    Male
    The fact that you're even asking this is beyond asinine.

    If you are HIV positive, you are a carrier and you CAN and WILL transmit to partners if you have unprotected sex.

    I also hate terms like "poz", like it's something ****ing glamorous that you collect.

    Your friend is HIV positive. He suffers from a degenerative, highly contagious condition with no known cure. This is not something you mess around with and say "well the load count is low so derpity derp".

    No. Just no.
     
  14. earllogjam

    Gold Member

    Joined:
    Aug 15, 2006
    Messages:
    5,027
    Likes Received:
    21
    Low or Undetectable Viral Low: Lower Chance of Transmission?

    Answered by Oliver Bacon, MD, HIV InSite Medical Editor


    Question

    I have met a guy who just told me that he has HIV positive after the night we messed around, and he said that he has a low viral load and I shouldn't be concerned about getting infected. I gave him oral and there was precum. He also gave anal but it didn't really go all the way. Now I am worried that I may have been exposed now after that night. Is it true that I have a very low chance of getting it since he had a low viral load count?


    Answer

    I'm sorry to hear that you are going through this. Yours is a difficult question to answer, because no study has examined this question directly (there is a large, multi-country study of this subject underway, but we won't know the results for a long time -- several years at least). Nevertheless, many people have started assuming that a low viral load means a low risk of transmitting HIV. This is a tricky assumption. Here are some possible answers to your situation, none of them a sure thing:

    1. If he is not taking antiretroviral therapy and his viral load (the amount of HIV measured in his blood) is still very low (less than 1,500 copies per mL of blood), then it appears that his likelihood of infecting you is low. This is based on a study of Ugandan couples, none of whom were taking antiretroviral therapy, in which one partner was HIV positive and the other was HIV negative. When the HIV positive partner's viral load was lower than 1,500 copies/mL, transmission to the HIV negative partner was not observed.

    2. If his viral load is low because he is taking antiretroviral therapy, then it's difficult to know his risk of infecting you. While most studies show that antiretroviral therapy suppresses viral load in both the blood and in semen, some other studies show that people can still have a detectable (and even high) viral load in their semen or vaginal secretions despite having an undetectable viral load in their blood.

    3. Also, just because his viral load was low last time it was checked, doesn't necessarily mean it was low when you had sex with him; other infections, especially sexually transmitted infections such as syphilis, gonorrhea, and chlamydia, can temporarily raise someone's viral load.

    So it's hard to say what your risk from this encounter was. If it's been within 72 hours since you had sex with him, I would strongly encourage you to seek PEP (postexposure prophylaxis, or one month of combination antiretroviral therapy) as soon as possible. In any case, getting tested now, in one month, and in three months is a good idea, as is wearing a condom during sex.

    Best of luck.



    Back to: Questions sorted by topic


    About | Site Map | Feedback | Subscribe | Donate | Disclaimer

    HIV InSite is a project of the UCSF Center for HIV Information. Copyright 2011, Regents of the University of California.
     
  15. earllogjam

    Gold Member

    Joined:
    Aug 15, 2006
    Messages:
    5,027
    Likes Received:
    21
    I appreciate your safe sex message here but I believe it's better to be informed with current understanding of the risks of HIV infection than spew outdated information and uninformed opinions as yours.
     
  16. hung9mike

    hung9mike Well-Known Member

    Joined:
    Jul 4, 2004
    Messages:
    688
    Albums:
    2
    Likes Received:
    711
    Gender:
    Male
    Location:
    Fort Lauderdale (FL, US)
    "Undetectable" does not imply the absence of the virus. In fact, any "negative" test for the virus simply means that the test is incapable of detecting the virus (because of the low level of the virus), not that the virus does not exist. Your partner, should he have a test for HIV today, would show a negative result. This does not imply you should have unprotected sex with him. Have him wear protection.
     
  17. hairyversmuscle

    hairyversmuscle Well-Known Member

    Joined:
    Mar 12, 2010
    Messages:
    533
    Albums:
    3
    Likes Received:
    372
    Gender:
    Male
    Location:
    Midwest - USA
    I don't even know where to begin, the fact that someone is wondering this. Undetectable does not mean cured! It is still transferable. If you want to live a long healthy happy life with lots of sex in it, wear a fucking condom! If you want to die young or live a very tough unhealthy life then go on with the unprotected sex and chancing it!
     
  18. huskielover

    huskielover Member

    Joined:
    May 17, 2008
    Messages:
    71
    Likes Received:
    6
    Gender:
    Male
    Location:
    Boulder (CO, US)
    I just copied this from my latest online testing results on HIV testing.

    *HIVPCR: REFERENCE RANGES:
    <48 copies/mL = Negative
    49 - 10,000,000 copies/mL = Quantitatively positive
    >10,000,000 copies/mL = Positive, above linear quantitation range of assay
    This test employs the Roche COBAS Ampliprep/COBAS Taqman 96 HIV-1 test which has been approved by the FDA for in vitro diagnostic use.


    I have been HIV+ for an unknown number of years now. Six years ago my CD4 count was down to 12! Normal starts at around 425. That is when I discovered i had advanced HIV disease. I have been undetectable for five years now. But if I have less that 48 copies of the virus in one mL of blood then that means I could have around 235,000 in my blood considering 47 copies of the virus in a mL--technically undetectable--and I have approx. 5,000 mL of blood in me right now. A mL is 1/1000 of a liter and there are about 5 liters of blood in the average human body. And I do not know how much of that may end up in my semen.

    Undetectable does not mean virus free. And something else to consider. HIV virus can hide in body tissues at a greater concentration than in the blood.
     
  19. TomCat84

    Gold Member

    Joined:
    Nov 23, 2009
    Messages:
    3,497
    Albums:
    1
    Likes Received:
    32
    Gender:
    Male
    Location:
    San Diego, CA
    WRONG WRONG WRONG! STOP the fear mongering! Would I reccommend he wear a condom? ABSOLUTELY! But not to protect himself from HIV. I'd want him to wear a condom to protect from the clap or syphilis. First of all, if the guy really was undetectable AND on anti retro viral meds (and wasnt lying about either of those), research has suggested the risk is fairly low. HIV is NOT "highly contagious"...in fact, it's probably one of the hardest STDs to contract- much harder than contracting herpes or genital warts.
     
  20. B_VinylBoy

    B_VinylBoy New Member

    Joined:
    Nov 30, 2007
    Messages:
    10,516
    Likes Received:
    7
    Gender:
    Male
    Location:
    Boston, MA / New York, NY
    TomCat84 already debunked your statement, but let me provide a life example that goes beyond that. One of my best friends is "poz" (I honestly don't care if the abbreviations or the slang offends you at this point) and has been in a long term relationship with their partner for nearly 8 years. His partner is negative, and still is to this day... on top of this, they have had some levels of unprotected sex throughout their relationship.

    Keep in mind, this is not an endorsement of any kind for anyone to go around having unprotected sex without any concern of risk. However, for you to say that positive people can and will transmit is bullshit. While I understand why some people may not want to have sex with someone that they know is positive in fear of contracting the virus themselves, it's foolish to translate that fear into a statement under the guise of fact. Everyone here, including yourself, have probably slept with someone who is positive by this point and most likely don't even know it. And just because you may have used a condom, that doesn't mean that there still wasn't a risk... just a much lower one than those who don't use them.

    With that said, it is my understanding that unprotected anal sex and bottoming is probably the riskiest act you can engage in. It is where body tissues, cuts and skin tears can happen the easiest, which is how the virus gets into a person's body to begin with. Undetectable viral loads do not mean an absence of the virus, so it's best to be safe even with this bit of information.
     
Draft saved Draft deleted