for Veterans and the Public
Frequently Asked Questions
Q: I am HIV positive, and I take HIV medications. My partner is HIV negative. Should he/she start pre-exposure prophylaxis (PrEP) medication to protect him/herself from becoming infected?
If you take your HIV medications every day and your HIV viral load always is "undetectable" (so low that it is not detected on lab tests), the chances of infecting your partner are very, very low. But a "very, very low" risk is not the same as zero risk, so we usually recommend that you as a couple take additional steps to prevent the HIV-negative partner from becoming infected. Preventative methods could include using condoms, avoiding riskier forms of sex, and/or PrEP.
PrEP refers to a medicine (Truvada) that is taken by HIV-negative people to reduce their risk of becoming infected. PrEP is highly effective if it is taken correctly and consistently, every day. The U.S. Centers for Disease Control and Prevention (CDC) recommends that we consider PrEP for anyone who has a sex partner or injection-drug-using partner who is HIV positive. So, this would apply to your partner. We do not yet have scientific data to tell us whether PrEP will add extra protection if the positive partner's HIV viral load is continuously "undetectable" on HIV meds, but we should know more in the next few years. Certainly, if your partner has other partners (that is, if you do not have a monogamous relationship), PrEP will decrease his/her risk of getting HIV from those other partners. Your partner should speak with his/her health care provider about PrEP and get expert advice on whether PrEP would be a good HIV prevention method for him/her.
Q: I am HIV positive, and I do not take HIV medications. My partner is HIV negative. Should he/she start PrEP to protect him/herself from becoming infected?
If your HIV virus is not suppressed by consistently taking HIV medications (antiretrovirals, or ARVs), the risk of your partner becoming infected through sex or through sharing drug injecting equipment is quite high, unless you as a couple take measures to reduce this risk. Pre-exposure prophylaxis (PrEP) is medication (Truvada) that is taken every day by an HIV-negative person to prevent HIV infection. PrEP can be highly effective if it is taken correctly and consistently, especially if it is used in conjunction with other methods of reducing HIV risk (such as using condoms or sterile injection drug equipment).
The U.S. Centers for Disease Control and Prevention (CDC) recommends that we consider PrEP for anyone who has a sex partner or injection-drug-using partner who is HIV positive. So, your partner definitely should think about whether PrEP would be a good prevention method for him/her. He or she should speak with a health care provider to learn more about PrEP and other HIV prevention practices.
Coming back to you, I am very concerned that you are not taking HIV medications. We now have a great deal of scientific data proving that people live longer and healthier lives if their HIV is controlled with medications, no matter what their CD4 counts are or how well they feel at the moment. And, we know that your risk of infecting another person is extremely low if you are on HIV meds. So, please consider taking HIV medications -- for your own health as well as to prevent transmission to others.
Q: I am HIV positive. My partner is HIV negative and is taking PrEP. Do we still need to use condoms?
PrEP is highly effective at preventing HIV infection if it is used correctly and consistently, every day. But it is not 100% effective. Since you are HIV positive and your partner is HIV negative, it is recommended that you as a couple use additional methods of reducing HIV risk such as condoms while your partner uses PrEP. And you, as the HIV-positive partner, should take the HIV medications prescribed by your doctor.
Susa Coffey, MD
August 6, 2015
Transmission and Risk
- Can you reduce the risk of getting HIV after having unprotected sex with someone who has HIV?
- Why should you bother using condoms to prevent transmission when HIV is treatable?
- If taking anti-HIV drugs has made your viral load undetectable, can you still pass the virus to another person through sex?
- What are the risks of getting HIV if you put on a condom after you've already started having sex?
- Should a woman douche after a condom breaks?
- What are the chances of a man being infected with HIV after unprotected sex with a woman?
- Can you get HIV through oral sex?
- Is it safe for an HIV-positive person to have unprotected sex with another HIV-positive person?
- Will cleaning IV-drug needles and syringes with bleach before using them prevent you from getting HIV?
- Can two HIV-positive parents have an HIV-negative child?
- Can a couple in which one person is HIV positive conceive a baby without passing the virus to the uninfected partner?
- Can you get HIV or hepatitis C from blood or organs received from another person?
Testing and the Window Period
- Would you know whether you're infected with HIV without getting tested?
- How soon after risky sex can you be 100% sure you are clear of HIV?
- How accurate is the rapid oral HIV test?
- What do "inconclusive" test results mean on a home HIV test?
- Can I take hep C medications along with my HIV medications?
- Why change your HIV regimen when you've been on it for years, and it's working?
- If you change to new HIV medicines (ARVs), can you go back to the old ones in the future?
- When should you start antiretroviral therapy?
- Is there a once-a-day pill for HIV?
- What is drug resistance in HIV and how can you avoid it?
- What should you do if you miss a dose of your HIV medicines?
- Can you take a break from your HIV medicines?
- Will HIV medicines cause changes to your fat and stomach?
- Is it true that someone has been cured of HIV?