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Precum/co-infection in sero-discordant couples

Jan 17, 2010


i really appreciate the possibillity of asking you a question. my situation is as follows: i am hiv negative and my partner has been diagnosed positive, he got infected 6 months ago, before our relationship .now we are at the stage of figuring out the rules in our relationship based on collecting information. the main concern is that if we would have an open relationship and he would maintain his promiscuous lifestyle, then it only would be a matter of time until he would contract an std such as tripper or syphillis, thus i have allowed myself to list the following questions:

1) precum is known to contain the hi-virus and theoretically could cause infection even oraly. i therefore know that active oral-sex with someone hiv+ is not absolute safe sex but only "safer sex". how would the viral load in precum change if he would have an additional std such as tripper or syphillis? would the viral load be comparable to that of semen under normal circumstances? would you consider it to be "safe enough" to wipe away precum whenever possible whilst performing oral sex in that given situation where there could be an additional std in play or would your advice be to use a condom because the risk is significantly higher/closer to that of coming into contact with ejaculate in the mouth?

2) could an additional std increase the viral load in either saliva or urin that either of these fluids could cause an infection?

3) what long-term effects could stds have on someone that has been diagnosed hiv+? my guess is that the cd4 cells are weakend and the virus replicates more. dies this mean that every additional std/infection has a potential negative effect on life expectancy and begin of the hiv-treatment?

thank you very much,

Response from Dr. Holodniy

Unfortunately you are asking hypothetical questions that cannot be directly answered. It is true that other active infections (likely including STDs) can transiently increase viral load in the blood and likely in other bodily secretions, although the latter is less well studied or known.

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