Are " undetectable" poz guys ZERO risk to other barebackers?

[bbrt2012]

even in a world without anything infectious at all, i'd rather never have a razor near my hole at all.

[pigpozdad]

Undet = low risk, but many guys are cross-breeders with various other STDs, so the risk comes actually from the STD side (gonno, syph, chlam); many got the big bug (as a co-infection)

[ffoz]

razorblade? use a toothbrush........do it right.

[Rawbbguy14]

I had the same question and still do. I just found out I was poz in jan of 2014. It was mind opening and the doctor only said great thing about my cd4 and my VL. I have a partner tho and his test came back negative. The question we are dealing with now is what do we do.

I found this article to help a lot.

http://www.natap.org/2013/HIVwomen/HIVwomen_01.htm

As long as you keep yourself health, and know what your cd4 and VL is at. The risk is the same as a condom, in my personal option.

[nekofox]

NOTHING is truly zero risk. Usually, at best, you're looking at a 5-10% chance of getting it, or even lower, but the possibility is still there.

[GermanFucker]

The risk is the same as a condom, in my personal option.

I think this BY FAR THE BEST RULE OF THUMB: Being undetectable is AS SAFE AS USING A CONDOM.

[wood]

I think this BY FAR THE BEST RULE OF THUMB: Being undetectable is AS SAFE AS USING A CONDOM.

looks like things may be headed that way, even for gay men.

http://www.aidsmap.com/No-one-with-an-undetectable-viral-load-gay-or-heterosexual-transmits-HIV-in-first-two-years-of-PARTNER-study/page/2832748/

[Poz1956]

If you want to watch listen to the audio, watch the slides, and hear the Q & A at the end of the presentation, here is the actual presentation at CROI 2014. (Conference on Retroviruses and Opportunistic Infections)

The only way you can ethically do research of this kind, is long term follow up of couples in mixed HIV status relationships.

The Swiss statement (there was no Swiss study), and others were based on HPTN 052, a study of third world heterosexual serodiscordant couples ( mixed HIV status couples, one Poz - one Neg, also called Magnetic, or seriodivergent couples). Both men and women in that study were Poz (technically both tops and bottoms by our terminology). It showed that a Poz person, under treatment was 96% less likely to transmit the virus than a person Not under treatment (Note the LESS likely -- 96% lower than the already low bottom to cut top 1 in 909, moderate bottom to uncut top 1 in 161, and high to to bottom 1 in 71 chances). There were lots of unanswered questions left by HPTN 052. Couples at least claimed to use rubbers most of the time. There were only 33 gay couples in that study, so there was too little info to draw any conclusions about us guys fucking around.

The European based Partner study was designed to fill in those gaps. The couples bareback at least some of the time (logically most of the time). It included both straight and gay couples, with enough gay couples to make the results valid. Based on the number an type of sex acts, the researchers would have expected 86 of the gay Neg partners to become Poz. There were an estimated 16,400 gay sex acts, and 28,000 straight ones. In the first two years of the study, NONE of the Neg partners caught HIV from their Poz spouse. A little over a third of the gay couples fucked around on the side (3 ways? Open? Opps-- hee hee - He was just so hot?) and they BBd in those outside flings. About half of the ones who fucked around caught an other STI.

The STI stuff implies that catching one may not spike the Pozzie's viral load, and may not hugely impact the Neg sustainability to catching HIV from an undetectable partner.

Some of the Neg partners did catch HIV, but gene sequencing on their version of the virus proved it COULD NOT have come from their Poz partner. They caught it from fucking around outside of the relationship.

So far this study has more than three times the "couple years of follow-up" of all other studies combined. To an epidemiologist following a large number of couples from one to two years, is the same a following one couple for a large number of years. With a cumulative 894 couple years of follow-up, and zero actual transmissions, there is sufficient data to draw statistically significant conclusions. But with statistics, they throw in a funny thing called a "confidence level." They are 95% certain that their results are correct. That 95% confidence level leaves the worst case theoretical possibilities of transmission, and those are the risks of transmission quoted in the study. They know the actual results lie somewhere within the boundaries between zero and those % risk, but they don't know where. At a press conference after the presentation, the head researcher said that it was more likely that their chance of acquiring HIV from their partner was nearer to zero, and indeed could be zero.

While they may never be able to prove absolutely zero chance of transmission, I'd bet the chances of catching from an undetectable Pozzie will turn out the lower, than Mr. "Clean U B 2" who isn't quite as clean as he thought. Depending on who's stats you look at, between 25% and 44% of all Pozzies DO NOT KNOW they are Poz

The one area where this study does not have enough data yet, is a Poz top dropping his load in a Neg bottom. Even though NOBODY got infected, that 95% confidence level makes them show a 4% risk for that scenario.

This is just the preliminary report. For phase two of the study they want an additional 450 European base gay couples in serodiscordant couple and will follow them until 2017. That will give them enough date to Raise the confidence level, and LOWER the theoretical risk much closer to zero. Hey, your UK and European guys in relationships, SIGN UP!

When asked what the study tells us about the chance of someone with an undetectable viral load transmitting HIV, the presenter said: "Our best estimate is it's zero." When people from a major research study, presenting in front of a room full of epidemiologists, internal disease specialists, and HIV service organizations makes an Estimate, you can be pretty damn sure it is a VERY educated guess. They won't risk their reputations.

I keep saying, there is a certain irony in the fact us undetectable Poz guys, who the Neggies are most afraid of, are probably going to turn out to be the ones LEAST LIKELY to infect them!

There is another study in Australia called "Opposites Attract" that will provide backup data. In it they can't ask the Pozzies about their BB activities, because laws would require the researches to report it to the police. They will only be able to question the Neg partners. (That may also have been the case in the Partner study, because BB was only reported from the Neg spouse's point of view.) The .AU study has a sub-component that will look at the seminal viral load of the Pozzies (bugs in the sperm). It is also due to report in 2017.

I wish they were checking the viral load in anal mucus as well. Guess we'll have to wait for some other study to look at that

Edited March 17, 2014 by Poz1956