Dear Dr Remien,

I'm an HIV+ man, diagnosed 8 years ago, in good heath conditions (thanks to continuous therapy), undetectable VL, CD4 around 600. It's been more than 1 year now that I have a great relation with a wonderful man. We love each other truly and deeply, which is an incredible blessing, the first one in my whole life.. except that I still experience real problems in sharing intimacy, because of my partner's excessive and unfounded fears about transmission risks.

The entity of these fears is such that in 1 year we didn't even manage to kiss truly! Here's a list of zero-risk activities that yet are perceived as a risk too much uncomfortable to take:

- my lips on any mucosal tissue (even dry kiss impossible) - touching my intimate parts with his hands without a glove - my lips on any part of his skin cause also anxiety

I asked him to read the ACTUAL risks on the magnetic couple forum.. Answer: - anywhere on the web the stated risk for kissing is low, but still bigger than zero. Saliva has small amount HIV, but still not zero: impossible mathematical proof that it is zero risk.

I do know about the actual risks. Telling him that in the past other people had little or no pb in kissing me deeply from the very first time I disclosed my status, this didn't work. Strange enough he is not scared to be the insertive partner with the protection of a good condom!

The current situation makes me suffer, I fear we won't ever be able to break these barriers. How can we go through this? How can I hope that one day we will at least kiss properly?

Any help is deeply appreciated.

You are asking a very difficult question since he seems to be rather extreme as well as stubborn with his fears. It is hard to know what, if anything would be reassuring to him. If he hasn't already, I suggest that he speak directly with a physician about this. This should be a physician who is knowledgeable about HIV specifically and who would provide the time for him to ask a lot of questions. Also an experienced counselor who works in the field of HIV could be helpful to you both.

Good luck with this since I am sure it is quite frustrating for you to not be able to be more physically intimate with him. Let's hope that there is still room for some reasonable changes on his part.