Stop HIV & hep C now

Your partner’s got HIV, but you’ve got options

By Andrea Arscott, Senior Columnist

You and your boyfriend have been dating for a while now, and you feel the relationship is going to progress to the next level—a sexual level. You decide it’s time for a chat about testing for HIV and other sexually transmitted infections (STIs) and take him out for a picnic in a quiet park where you will both be relaxed. That way, if your partner has an illness or infection to tell you about, he will be more likely to open up. After some food, you bring up your own experiences with HIV and STI testing and ask him if he’s been tested lately.

He hesitates, then responds: “I want to be honest because I really care about you, and I’d love to see where this relationship is headed. I’m really glad you brought this up because I wasn’t sure how to do it, but I am HIV-positive.”

He goes on to explain that although the virus is in his body, the anti-HIV drugs he takes have resulted in an undetectable viral load (the amount of the virus in his body fluids). This means the risk of HIV transmission during protected vaginal sex is extremely low.

Although you’re surprised and a bit worried, you have feelings for this guy and want to give him a chance. You bombard him with questions and jump way ahead and ask him if he can have kids. He says, “Unless I have a sperm problem that I don’t know about, yes, I can. But even though my viral load is undetectable, there’s still a risk, so we’d have to weigh the pros and cons with my specialist.”

A webinar at Catie.ca states there is a 0.08 per cent chance of HIV transmission during receptive vaginal sex without a condom, but this number increases as the number of unsafe sexual acts increase. The webinar presenter, James Wilton, offers an example: after 300 exposures, there’s a 25 per cent risk of being infected with HIV from your HIV-positive partner. Wilton therefore warns that the percentages should not be underestimated.

If the two of you eventually choose to engage in condomless sex or want to try to have a baby, you’ve got options. One of those options is called PrEP (pre-exposure prophylaxis). PrEP is an anti-HIV drug that HIV-negative people can take to reduce the likelihood of contracting the virus from their HIV-positive partners. You could consult a doctor to discuss the benefits and disadvantages of taking PrEP on a daily basis.

As with any medication, there are side-effects. Catie.ca’s fact sheet on PrEP says that anti-HIV drugs “may negatively affect a person’s quality of life.” If a person starts PrEP and contracts HIV while taking these medications, but is not aware they’ve been infected, they could develop resistance to the drugs. This is problematic because the drugs are the same ones used to treat HIV.

The riskier activity would be to engage in condomless sex with a male stranger who is unaware he has HIV because the last test he had didn’t include his sexual partners from within the one- to three-month window period. A person in this acute stage of HIV is extremely infectious and can pass the virus on more easily than someone who has had HIV for years. This means their viral load is high, which, according to Wilton, can increase the risk 26-fold.

Although PrEP is not approved in Canada, Catie.ca advises that some doctors may be willing to prescribe it “off-label.” They also warn that PrEP shouldn’t be considered as a replacement for condoms, as it only provides partial protection against HIV and doesn’t protect you from other STIs.

According to Positive Living BC, in Canada there are an estimated 71,300 people living with HIV/AIDS, and according to Newsroom.gov.bc.ca, 13,000 of them are British Columbians. Since HIV doesn’t discriminate, you cannot recognize the face of HIV. The only way to know if your sexual partners are HIV-positive is to ask them when they were last tested. Don’t raise the topic when you’re in bed with the person or about to get it on at the drive-in—this discussion requires a little pre-planning and some careful consideration.

Stop HIV now. Know your options and protect yourself and others.

The Purpose Society testing clinic at 40 Begbie Street in New Westminster will be providing anonymous and rapid HIV testing and STI and hepatitis testing on January 16. It will also provide vaccines, free harm reduction supplies, and condoms! Any questions? Email the Purpose Society at sexyquestions@purposesociety.org for a free, discreet answer.