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please, need help with my mixed status relationship
Dec 31, 2003

Hi,

I am a hiv positive woman and I have been with my boyfriend who is negative, for 6 years. He has been great about putting up with the sexual limitations and the strain that hiv puts on a relationship. We really love each other, but I feel bad because he is young and I am the only person he has been with and I know that he would like to have unprotected sex with a woman, preferrably with me, but I don't think that's possible. He asked me to look into it, and as far as I can tell there hasn't been a lot of research into finding something that would kill HIV in the vagina. Do you think this could be true:

It is possible to destroy HIV or interrupt its transmission, and 60 candidate entities have been shown to hold promise in this field. Nine INDs (Investigation of New Drug) have been filed with the FDA, but none have entered phase 3 clinical trials. However, big pharma is not interested in a niche market and the few small companies who are willing to work on microbicides are under-capitalized. Several non-governmental organizations have worked in the field for over a decade, but have failed to bring a microbicide to market.

If it is true that they aren't being researched as aggresively as other things (like hiv meds)I am really mad. Being able to have a relationship is just as important to my quality of life as having hiv meds. Why aren't they working on this more aggressively? Do you know if there are any microbicides being developed?

I am really sad that my boyfriend isn't happy sexually, and I can't decide what to do. I'm not thinking about putting him at risk. I just want to know if there is anything being developed that might give us hope for having a normal sexual relationship somewhere down the road.

We both want to be together for the long haul, and we both want something to look forward to. Do you think eventually, something will be developed? I'd love to hear about anything that's being researched or considered. Do you predict that maybe in a few decades we will have options? We'd both really like to be able to look forward to being as close sexually as we are in every other way! Thank you so much. I really appreciate your answers.

abi

Response from Dr. Remien

Thank you for your question. Unfortunately, I am not able to tell you about anything you don't already know. You are obviously fairly well informed on the issues related to microbicide development. There are products that are in various stages of development and many specialists in the field have been advocating for faster development and testing of such products, although many, like you, feel that not enough is being done. And I agree with you, sexual quality of life is important and valuable and needs to be acknowledged as such.

This is not my area of expertise, but I do think that it is a matter of time (hopefully sooner rather than later) that we will have safe and effective mocrobicide gels that can be comfortably used by men and women for sexual intercourse. In the meantime, it is important to continue to work with each other to protect yourselves from the transmission of HIV and other possible sexually transmitted infections. Many couples find the female condom to be a welcomed alternative to the male condom. If you and your boyfriend have not tried using it, I suggest you give it a try.


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