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Having a relationship based on trust, commitment and familiarity helps Australian gay men rely on undetectable viral load as a means of HIV prevention, according to interviews with HIV-positive and HIV-negative members of serodifferent couples. Confidence in the protective power of an undetectable viral load is also strengthened by receiving consistent test results after repeated condomless sex, according to a qualitative study recently published in AIDS and Behavior. Steven Philpot of the Kirby Institute interviewed 21 men who were taking part in Opposites Attract — one of the pivotal studies which demonstrated that HIV-positive people who have an undetectable viral load do not transmit HIV to their sexual partners. Participation was not restricted to couples with any particular HIV prevention strategy or sexual practice. A month-long course of antiretroviral medicines taken after exposure or possible exposure to HIV, to reduce the risk of acquiring HIV.
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Prophylactic ART in HIV serodiscordant couples | Nature Reviews Urology

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Living with HIV when one partner is positive and the other is negative

One doctor told her that she would be dead within five years. WHO estimates that globally as many as half of all HIV-positive people in long-term relationships have HIV-negative partners — forming what are known as serodiscordant couples. Receiving voluntary HIV testing and counselling as a couple means that both partners get tested together, receive their results and share their status with the support of a counsellor. A range of prevention, treatment and support options can then be discussed and decided upon together. Maripaz is now married to Moises Marinero. Maripaz was reluctant to start a new relationship at first, but a counsellor told her that it was safe to have sex, provided she always used a condom.
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Prophylactic ART in HIV serodiscordant couples

A mathematical model derived from current knowledge about the efficacy of various different prevention strategies has found that, based on these data, the risk of HIV transmission from a person living with HIV to an HIV-negative partner in a serodifferent couple could still be substantial over a ten-year period. The authors state they undertook their research because people in serodifferent couples often referred to as serodiscordant require guidance about the likely impact of emergent prevention strategies such as treatment as prevention and pre-exposure prophylaxis alone, or in combination with each other, on the risk of HIV transmission. They therefore estimated the risk of sexual transmission of HIV over one-year and ten-year periods for gay and heterosexual couples. The risk for heterosexual couples was modelled separately according to whether the male or female partner was living with HIV. The authors, publishing in the online edition of AIDS , emphasise that their model does not say what the actual risk will be.
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