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Ask the Experts about Mixed-HIV-Status Couples
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Unprotected Sex with Positive Partner
Oct 20, 2006

I have been in a relationship for a year with an HIV infected partner. We are both almost 30 and feel our relationship is healthy and in a great place. A few months ago I decided not to use condems anymore. We talked a lot about it, but I just don't want to use them any longer. I am strictly the top in the relationship and we are monogomous. Neither of us have any other STDs and we are in good health. He is on meds and is undetectable. Am I being rediculous to not use protection?

Response from Dr. Remien

Whether you are being "ridiculous" or not is a matter of judgment and I imagine many people can disagree on whether you are or are not being ridiculous.

Are you taking a significant risk? YES, you are, because HIV transmission can occur.

Is it a calculated risk based on some of the evidence? Well - it does seem to be true that there is less risk for the insertive partner than the receptive partner. And there is added reassurance when there are no other STDs present and his viral load is well controlled. However, transmission does occur from the "bottom" to the "top" and can occur no matter how low the viral load.

My recommendation is to stick with protected sex and play with ways to continue to enjoy your "safer" sex. For most people, sex is much more pleasurable when there is little anxiety. The choice is ultimately up to you. Just know that there is risk involved if you decide to abandon condoms altogether.



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