My boyfriend and I haven’t had sex yet. He told me he has HIV, but is being treated and so he can’t pass it on. I trust him, but I’m still really nervous. If we had sex, couldn’t he infect me?
Great question! Your boyfriend must really trust you to tell you about his HIV status. This can be really, really hard for some people.
If you haven’t already, it’s worth refreshing yourself on some HIV basics here. HIV stands for human immunodeficiency virus. It attacks the immune system, making it difficult for the body to protect itself from getting sick. HIV can be spread through blood, semen (or come), vaginal fluids, rectal fluids, and breast milk—NOT through saliva or casual contact.
HIV is a manageable virus, but it’s not curable. This means that once you have HIV, you have it for life. However, it’s NOT a death sentence. People with HIV who stick with their treatment live long, healthy, normal lives.
Unfortunately, HIV stigma (which we talk more about here and here) is still alive and well. This means that many people still have harmful and flat out wrong ideas about HIV—that you can tell someone has it by looking at them, can get the virus from sharing a drinking straw, or that only “promiscuous” people have HIV. None of this is true. Having HIV says NOTHING about who you are as a person.
With antiretroviral therapy, most people can decrease the amount of HIV in their body (also called the viral load) to undetectable levels. Once the viral load is undetectable, the virus cannot be transmitted. You may have heard or seen the phrase, “undetectable = untransmittable”—this is what it’s referring to. You may see some information online saying that the odds of transmitting the virus with an undetectable viral load are very low, but not impossible. However, years of research has supported the conclusion that HIV cannot be passed on with an undetectable viral load. The CDC has recently, finally acknowledged this (yay!).
This means that if your boyfriend has an undetectable viral load, you cannot get HIV from him. Not everyone who is being treated has an undetectable viral load though, so check in with him to make sure that that’s what he means.
It’s very important that your boyfriend follow his medication regimen and see his health care provider as often as recommended. If he doesn’t, it’s possible for his viral load to increase without his knowledge. Even though there’s no reason to not trust him, your boyfriend’s behavior is ultimately out of your control. If you do have sex (of ANY kind), using condoms will give you more control over your own sexual health and protect you against HIV in the (unlikely, but possible) case that your boyfriend’s viral load has increased without his knowledge.
Using condoms is also a great idea because HIV isn’t the only sexually transmitted infection (STI). You should both also still get regularly tested for STIs. Remember that some STIs like chlamydia and gonorrhea can also be transmitted through oral sex, so consider grabbing some flavored condoms.
If it turns out that your boyfriend is getting treated for HIV but DOES have a detectable viral load, he CAN pass on the virus. If you decide to have sex, make sure to use condoms (the right way, every time). Consider talking to your health care provider about using PrEP, a daily pill that greatly reduces the chances that you’ll get HIV. We talk more about it here. If a condom breaks or slips off, or you forget to use one, you can get PEP from your health care provider, the emergency room, many walk-in clinics, and for free at Mount Sinai Adolescent Health Center. PEP is kind of like the Plan B of HIV—it can be taken up to 72 hours after exposure to HIV, and greatly reduces the chances that you’ll become HIV+.
It’s great that you’re educating yourself about HIV. This is a wonderful way to support your boyfriend. If he’s out about his HIV status, educating yourself means you can be an advocate for him, and dispel any myths others might believe about HIV. Of course, do NOT tell others about your boyfriend’s diagnosis without his explicit permission. This is a serious breach of trust, especially since you can’t be sure how others will react to this information.
If you have any other questions about HIV, are 10-22 years old, and live in NYC, you can come to the Mount Sinai Adolescent Health Center for free, confidential health care, including STI testing and treatment, PrEP and PEP. We also have an HIV treatment program called Project IMPACT. If your boyfriend is 13-24 years old, he can get free, confidential HIV treatment and join our support group for HIV+ young people.