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What planet is this guy from?
Jan 29, 2006

Hi Dr. Bob,

I follow your forum and it is rare that I feel the need to address someone else's comment but I really can not let this one go. Here's what he/she said:

You also need to know with confidence that your partner(s) are not HIV positive. ASK! And if he refuses to answer, or says he is positive, it's sayonara, buddy. (If he is negative, still use condoms, unless and until he and you commit to an exclusive relationship.)

This approach may mess up the occasional planned evening of fun--but it will keep you alive. This is the single most effective HIV prevention strategy for gay men. [End Quote]

The single most effective prevention strategy for gay men??? That's like saying the single most effective prevention strategy for protecting your house from being robbed is to leave your doors unlocked.

Asking someone if they are HIV positive is simply not a sufficient strategy for protecting yourself from HIV infection. Believe it or not, PEOPLE LIE! Furthermore, it is estimated that approximately one-fourth of those carrying the virus do not know their HIV status!

As to condoms breaking, there are strategies to prevent this from happening such as placing a drop of water-based lubricant in the tip of the condom, lubricating the penis before putting on a condom (with water-based lubricant), and making sure there is plenty of room in the tip of the condom to deposit semen. When used properly, condoms are generally 98-99% effective.

My boyfriend is positive and I am negative. I love him very, very much and would be missing out on a great life together if I ditched him just because of his status. We have never had a condom break, but if we did I have an antiretroviral cocktail ready to begin PEP treatment. I do not favor PEP as a prevention strategy, but if a person has been exposed to HIV it is imperative that they know PEP (if begun within 72 hours of exposure - really more like 24 hours) can reduce the risk of seroconversion. The sooner one gets on the meds (half-hour to three hours after the exposure), the greater the chance they have of staying negative.

An educated negative gay man

Response from Dr. Frascino


I, too, prefer not to specifically address comments made by someone else, particularly because such comments may be incomplete or taken out of context and therefore misinterpreted.

I will say that I agree with the author that no matter what a potential partner may say, condoms should still be used. (Even if he had a lie detector strapped to his Mr. Happy, I would not recommend believing what a horned-up hottie might say while telling you to grab your ankles. Remember one of Dubya's favorite lines is "just trust me" and we all see how well that's worked out . . . . Talk about getting screwed!!)

I will also say that I agree with you about the "sayonara buddy" comment.

Stay safe. Stay well.

Dr. Bob

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