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Poz man, Neg woman, we choose unprotected sex
Aug 20, 2011

What are our odds of my transmitting HIV to my girlfriend? Vaginal and oral sex only and I ejaculate inside her. I am undetectable, and have been for many years, but I cant seem to get my CD4 up over 350. While we both agree to this, I am still a bit concerned. Condoms dont work as I already have a big problem with erectile dysfunction much of the time. We enjoy being naked, cuddling, and being intimate, and love to have sex. I am serious about this woman, love her, but I dont know what to do.

Response from Dr. Frascino

Hello.

The CDC's estimated per-act statistical risk for acquiring HIV from unprotected receptive penile-vaginal intercourse and unprotected receptive oral sex with a partner confirmed to be HIV positive is 10 per 10,000 exposures and one per 10,000 exposures respectively. That you are presumably on effective antiretroviral medication and your HIV plasma viral load has been undetectable for many years significantly decreases, but does not completely eliminate, any HIV-transmission risk.

Latex condoms, properly used, would offer the best protection against HIV transmission. If you are having difficulty with erectile dysfunction (ED), you should discuss this with your HIV specialist. An evaluation is warranted to ascertain the potential cause of your ED. Hypogonadism (low free testosterone levels) is a common cause seen frequently in HIVers. Treatment with ED drugs (Cialis, Viagra) and/or a physical device (such as a "penis pump" vacuum and/or cock ring ) could be tried.

You and your partner should peruse the information in the chapter devoted to magnetic couples in the archives of this forum. There are a number of harm-reduction strategies you might want to consider, particularly the use of PrEP (pre-exposure prophylaxis) for your negative girlfriend. If you truly love her, you'll want to do absolutely everything possible to protect her from acquiring the virus.

Good luck! Just for information purposes I'll point out that I've been in a magnetic relationship for over 17 years with my legally-wedded spouse Steve (Dr. Steve, the expert in The Body's Tratamientos forum). Happily-ever-after, including mind-blowing, toe-curling, wake-the-neighbors fusion sex, does indeed exist for magnetic couples. Because of my love for him, I absolutely could never purposely put him at risk.

Good luck.

Dr. Bob


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