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TheBugDoctor, Doctor (MD)
Category: HIV and AIDS
Satisfied Customers: 1747
Experience:  I am a Board Certified Infectious Diseases physician with many years experience treating a broad range of infectious diseases.
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I had unprotected sex with a male who is HIV+ He is on meds.

Customer Question

I had unprotected sex with a male who is HIV+ He is on meds. He is undetectable. I did not use a condom when I had anal sex with him. He was the receptor. I had unprotected oral sex with him but he did not ejaculate in my mouth and he does not have a lot of precum, very little if any. He ejaculated over his chest. In the heat of the moment I licked two of the spots. How much at risk am I? I have been having sex with him prior to this. I have had 2 tests and both negative. Concerned.
Submitted: 2 years ago.
Category: HIV and AIDS
Expert:  TheBugDoctor replied 2 years ago.
As a general rule we recommend use of condoms for sexual contact with an infected partner. Having said that, in Switzerland they put out national guidelines saying that condoms are not necessary if a partner consistently has an undetectable viral load ( not necessary for HIV protection but obviously there are other STDs- like syphilis, gonorrhea, chlamydia).
I write that to make the point that if his viral load truly is undetectable, your risk is actually extremely low.
Having said that, this protection is not 100% and there are some men who can have an undetectable VL in blood and still some HIV in semen.
If this sexual activity just occured, many experts would still advise PEP"- post exposure prophylaxis- medications you take for 4 weeks to further lower your risk. I would consider this optional in this case, if you are confident he is undetectable. If you have any doubt, this may be a good idea.
Finally if you continue to have sex with him, and you are motivated to optimize your protection, you 1) should use condoms and 2) may want to consider "PrEP"- Pre-exposure prophylaxis taking Truvada daily.
I hope that helps
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