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Worried...
Jun 4, 2000

I am a 27 year old gay male. I have just met a guy who is negative. I told him of my status on the upfront and he is accepting. He wanted to have intercourse with me using a condom but he changed his mind and went without one anyway. I told him it bothers me he doesn't want to use a condom but that is his decision.. he is a top and of course doesn't want me to top him with or without a condom... but I really like him and don't want anything bad to happen.. How should I handle this situation? How much is he at risk being a top unprotected?

Response from Dr. Remien

I am not going to get into the details about level of risk, because I imagine you already know the answer: while it is less risky as a "top" than it is as a "bottom," there is still risk for the transmission of HIV, as well as other STDs. And this includes the risk of other STDs to you, something you don't want to have if you are living with HIV. And I don't agree with you when you say that it is "his decision." What level of risk you and your partner are willing to live with is ultimately up to BOTH of you.

I actually think that your issues are more about respect and boundaries between the two of you. While it is challenging to negotiate such matters, it will be important for the two of you to discuss all of your feelings, about sex and risk, openly and honestly. This is still a new and developing relationship for you. I wonder what having unprotected sex really means to you. And if, as you say, you feel uncomfortable having unprotected sex, what is the message from your boyfriend if he still insists on it? That doesn't seem very respectful of you and your feelings. How WOULD you feel if he were to become infected with HIV?

Again, you are dealing with issues that require honest, open, and respectful discussion between the two of you. And if you really do have specific questions about risk, please submit your questions to The Body's Safe Sex and HIV Prevention Forum


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