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Choosing to have sex with my HIV+ive partner
Jul 13, 2001

Dear Dr. Remien;

I have a moral dilemma that I would appreciate you commenting on. I have recently met a man who is extrodinary, however he is HIV+ive; i'm -ive. I have told some of my friends and they are furious that I would subject myself to this danger. I, on the other hand have almost no fear when it comes to being sexually intimate with him. I will admit that we do frequently have 'unprotected sex'. His viral load is very very low. Personally, I very much dislike the use condoms. At the risk of sounding naive, I would rather take the risk to have more pleasurable sex. In addition, most everything that I've read about HIV/AIDS suggests that I should have a very healthy happy life living with the virus. Frustratingly enough, I can not locate literature that deals with similar moral issues. I know the risks of 'unprotected sex', but why is no one addressing the need for people to make personal choices. Please help...I am very content in my present relationship, but my friends think I'm insane...

Response from Dr. Remien

Let me start off by saying that it is ALWAYS a "personal choice" when it comes to having unprotected or protected sex that people make in their intimate relationships. You are not alone in some of the feelings that you express, namely that a lot of people do not like using condoms and some people would rather take a certain amount of "risk" for the sake of pleasure and intimacy. However, you do need to realize that (1) having a very low viral load does not guarantee there will not be transmission of HIV and, (2) while more and more people can expect to live a healthy and happy life with the virus, there are many people who suffer significant unpleasant side effects from their treatment for HIV and many people continue to suffer significant secondary infections and illness (and even death) because of their HIV infection. It is extremely rare to find a person living with HIV who would truly say "it is no big deal."

With that said, you and your partner need to weigh the pros and cons and seriously think about your options. There is no good reason why two people of "opposite" HIV status cannot have a mutually satisfying and healthy sexual relationship that includes mutual protection from HIV and other sexually transmitted infections. Stay informed, know the risks, and make your choices accordingly. But do not fool yourself by thinking that there is absolutely nothing to fear and that living with HIV is "no big deal."


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