The guy I am dating for the past two months is HIV pos. He is a great guy and dropped a hint the let me know on the first date. He has been very open about his life before and after HIV. We both come from backgrounds of loosing lovers in the past. We have not discussed circumstances around his loss but he is aware of mine (NON HIV loss). We have dated for 2 months and yet to have sex (yeah I know we are gay men that are almost trying to hetro). I am sooo very ready to have sex but know that he may not be ready. He says he does not have a problem with me being negative. I don't have a problem with his being positive, though I am sure I will have many questions for awhile. My question is two fold. One how safe is using a female condom for gay men during anal sex. Two.... am I out of my mind telling him that I will not use condoms for oral sex?

I used to teach AIDS education for a non profit. I know the risks but I have a couple of friends screaming that I am crazy for not wanting to use condoms for oral sex. As far as the female condom goes I have heard that it creates a bit more non condom feeling but have not tried one and want to know if there is risk in using one.

Darrin

Hi Darrin,

The female condom is made of two flexible polyurethane rings and a loose-fitting sheath. It is approved for contraception and HIV prevention during heterosexual vaginal sex. Its safety and efficacy for anal sex has not been proven. Consequently it cannot be formally recommended for this use. That said, certainly MSM (men who have sex with men) have nonetheless begun to use them for anal sex. Anecdotally it has been reported that they increase sensitivity for the insertive partner compared to latex male condoms. This is presumably due to the large size and polyurethane composition. I do know of one study that's a couple of years old now that found about 50% of men using female condoms for anal sex reporting problems, including rectal bleeding. Anecdotal evidence suggests that removing the inner ring, lubricating the inside, placing the condom over the throbbing woody, lubricating the outside and then entering the receptive partner eliminates some of the discomfort and trauma. Also one must take care that the outer ring of the condom doesn't enter the rectum during the backdoor action.

Regarding your second question, unprotected oral sex carries a low risk for HIV transmission. Each of us must determine what level of risk we are comfortable taking. One thing to keep in mind is that when you are part of a magnetic couple, you both need to agree on what level of risk you are willing to accept, based both on individual comfort level and medical facts. So even if you know the facts and are comfortable having unprotected oral sex, your partner may not agree. Communication is the key to a successful and healthy sex life. I suggest you read through the information on magnetic couples (serodiscordant couples) in the archives of this forum. Share the information with your new boyfriend. Write back if you have additional concerns. I do have personal experience in this arena, as I have been part of a magnetic couple for over 12 years. I am HIV positive and my partner Steve (Dr. Steve, the expert in The Body's Tratamientos Forum) is HIV negative. We continue to have a romance that others only dream about. And yes, it includes toe-curling, wake-the-neighbors passion. Certainly in our case, opposites do indeed attract.

Good luck.

Dr. Bob