Now I don't buy for a second that unprotected sex with someone who is on a drug cocktail is safe, but it seems logical that these new drugs would reduce the risk of transmission. What are your thoughts? Is there scientific evidence one way or the other on this issue?
Keeping It Wrapped
Hey, KIW: Whether HIV-positive men taking drug cocktails are less infectious depends on the amount of virus in their semen, not their blood. Some studies indicate that HIV-positive men with undetectable viral loads also have lower levels of virus in their semen. But other studies have demonstrated that some men on the drugs who have undetectable viral loads in their blood nevertheless have high levels of HIV in their semen.
"Triple drug cocktails probably do decrease the risk of someone transmitting HIV to another person (assuming the person taking them has an undetectable viral load in their blood)," said Dr. David Spach, co-editor of The HIV Manual and a professor at the University of Washington Medical School. "But we really don't know how much the risk is decreased. Based on all the information I'm aware of, I honestly believe someone taking the triple drug cocktails (and who has an undetectable viral load in their blood) could transmit HIV to another person."
Even if the drugs lower the risk of an HIV-positive person successfully transmitting the virus, they do not eliminate the risk. So unless you're in a monogamous relationship with someone you trust, or you're already HIV-positive and don't care about reinfection, or you don't care about getting infected in the first place, you should still be using condoms, drugs or no drugs. As for that guy who wanted to fuck you without a condom, he's either misinformed or he's an asshole. Either way, he's a danger to his sex partners, and I hope he never gets laid again in his long life.