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I don't beieve it's possible to be safe in a relationship
Feb 1, 2004

I love your column, you've taught me alot, and I'm a new gay man, so thanks.

I realized I was gay four years ago as a forty year old "straight" man with older teen kids. I immeadiatly told my wife (we later divorced) and kids and slowly settled the family and then came out publicallly and started dating about a year ago. These were the first ever gay experiences in my life- holding, hugging, oral and eventually real sex with the last guy. I'm Absolutely scared shitless of aids. I really want to stay alive and well for my kids sake. The sixth guy I dated in as many months swept me off my feet. He's been out for 25 years. We were so happy and compatible. I'm extremely cautious and although we were unprotected a few times I almost always forced us to use condoms. He was negative when we met, I saw his test, but when we went a month ago for testing- he was pos. I'm still neg. HIV has always been a major fear of mine, and moreso now seeing how sick he is with the medication. I don't want to have sex anymore, and cant' rationally see ever having it again---there really is only safer sex-not guaranteed safe sex, especially with a poz. partner. I guess if we love each other enough no sex again shouldn't matter...but I don't know how possible that is. Sex is important to him too. He got really hurt when I suggested we don't fuck anymore, just safer stuff. Hugging is more important and I feel that strongly, but I'm not ready to stop something---regular gay sex-- that I missed my whole life. The fact that I'm wondering...does it mean I don't love deeply enough, am a shallow narcissistic guy or what do you think? I just feel that if I continue to have regular-even safer sex with a positive partner....the odds are just piling up against me.

Response from Dr. Remien

First off, let me say that I know that it is a very difficult thing to make the kind of changes you made in your life, after having been married and having children. However, in the long run, I believe you will have greater life satisfaction, having made those changes, and it is likely that your family and loved ones will agree that this is what is best, given who you are.

And no, you are not a "shallow narcissistic guy" to have the fears and concerns that you have. It is not unnatural to fear HIV/AIDS and to want to remain HIV-negative. At the same time, things do need to be kept in perspective. While, there is never a "guarantee" that it couldn't happen, HIV transmission is something that can be prevented. And yes, anal sex is generally the riskiest of the sex behaviors, but consistent and correct use of condoms is highly effective in preventing the transmission of HIV.

Many people are entirely content without having anal sex - it is not something that all people enjoy. However, if it is important and pleasurable to you, and your partner, then I would advocate for you and he to work on being able to have this be part of your sex life, while also working together to keep yourselves healthy and free of anxiety about it. Again, be consistent with your use of condoms and make sure you use them correctly (e.g., use only water based lubricant, make sure the condoms are not expired and that they are put on correctly, etc.) In the event the condom ever breaks and there is ejaculation by your partner, you should consider a quick consultation with a physician and possible use of "post-exposure treatment." This would need to be done shortly after exposure (within 72 hours, but the sooner the better). If you and your partner are not familiar with this treatment, speak to his or your physician about it. Be prepared with a plan - don't wait for the accident to happen before trying to talk to a doctor about it.

However you both work this all out is up to the two of you. Keep an open mind and ask him to do the same. Talk about it and get all the information you need from doctors and counselors. Take care and be happy in your relationship.

Dating someone that is Negative
My finacee is HIV+ & I am -

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