Dr.,

I tested positive in Aug 2005. My partner of 15 yrs is, and remains, negative. He has been supportive throughout this challenge. In addition to the hiv, I've come down with herpes and anal warts since my diagnosis. I started meds in Dec and am doing well. I am somewhat scared to have sex with him, although we have had sex a few times over the last few months. I have always been the top, so the risk is great -- but I know condoms are effective if used properly. In addition to the hiv, I'm nervous about giving him herpes or warts (I'm having them removed on Monday), so the sex is nonexistant. Commnication in general has been a challenge for us, but it is an especially big challenge when sex is involved, this has led us to have an "assumed" open relationship. Assumed because we never said, No --- or Yes. We decided in Jan that we should give absolute monogamy a try. How do we communicate better about this -- and how do I get over my fear of infecting him. I feel so lucky that he is still negative. Guilt comes and goes for me, but the one thing I am sure of is that we both love each other and are determined to stick this out. I'm not sure if there is an actual question in here -- I'm just concerned at how we make this work.

You are right to be concerned, but if you use proper precautions, the risk of infecting your partner is low. I believe that the two of you need to discuss the issue further. The decision to have sex is one that each of you makes, and each of you shares the responsibility for any consequences. If he is fully informed, but decides to accept the risk (even though it is low), then you need not feel guilty. Your resposibility is to inform him and to carefully use precautions.