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New charismatic gay couple
Nov 18, 2011

Dear Dr. Fawcett,

I met a very nice guy and after seeing him for a month (sex excluded), I disclosed my status. He was shocked, but ended up saying that knowing that I have to deal with this virus made him respect me even more and that he would like to try to a charismatic relationship. Everything has been wonderful since then, except sex. I thought that the fear was going to come from his side, but I was wrong, I am the one terrified with the possibility of infecting him. I have decided to start medication (no previous need due to good cd4/viral load numbers), and I took also a general STD test. He knows that, but he still wants to have sex; I bottomed for him once, with condom of course. Moreover, he likes performing oral sex (unprotected) and I just freak out thinking that I may cum/pre-cum in his mouth and that he may have a sore or some lesion that could allow infection. I don't know what to do. I am starting this relationship, and I am afraid that my stress at the time of sex may have negative effects. I have been even freaking out thinking that no one else knows my status (except close family), so in a hypothetical conflict I have no proof that I disclosed (this last part just because of the news about people being prosecuted for not disclosing). So, all these things come to my mind during sex. He doesn't seem patient enough to wait until I get my viral load to undetectable and get my STDs results, and less worried than me overall.

What should I do?

Response from Dr. Fawcett

Thanks for writing. I'm not exactly sure how you are using the term "charismatic" but I can speak to issues of serodiscordant couples. I have found that it is quite common for the positive partner to be more concerned about passing the virus on to the negative partner. The thought of passing along HIV to someone you love is truly terrifying. Your chances of transmitting the virus are reduced as your viral load gets lower and certain sexual acts carry much higher risk than others. It is very important for the two of you to understand these risks and communicate about them. Be certain to convey to him your fears (and nothing kills the moment like anxiety). If might be useful to have a joint meeting with your physician where you both can review your options and have specific questions answered. Here a links to two resource pages: this one addresses many issues faced by serodiscordant couples, and this one has some tips for discussion and typical issues that such couples face.

In terms of protecting yourself after revealing your status, this disclosure guide from Ontario offered these suggestions: have witnesses when you disclose; double check by having a third party ask him is he knows you are positive; save online conversations and details; create support and counseling records by going to your doctor or a counselor and being certain there is documentation of his knowledge of your status, or sign a document.

Remember, communication is the key.

Take care,

David



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