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Question from South Africa
Aug 10, 2003

Dear Dr. Bob.

Greetings from South Africa. I am a heterosexual male and I would appreciate you answering/clarifying the following:

1. I have read (somewhere on this site) that the chances of being infected by HIV during a single act of intercourse is 1000 to one. Could you clarify if this is a) during PROTECTED or during UNPROTECTED intercourse and b) whether it is based on the assumption of sex between an HIV neg and HIV pos person.

2. I understand that the HI virus has to enter through a mucous membrane/s to cause an infection during intercourse. Is this membrane accessed through the urethra of the penis only or the head of the penis in general?

3. The third question is one about yourself and your partner (and please don't feel obliged to answer if you feel it is too personal). I understand that you are positive and your partner is negative. How long has your partner remained so and do you attribute him remaining negative due to proper condom use by both of you ? I would just like to ascertain, from the "horse's mouth" so to speak, the efficacy of condoms in sex in a sero-discordant relationship.

Look forward to your responses and thanks for the sterling work you do for the masses around the world.

Response from Dr. Frascino

Hello South Africa guy,

1. The risk of HIV transmission per episode of unprotected receptive vaginal intercourse is 0.1 0.2 percent. Yes, this is based on an HIV-infected source patient and HIV-negative partner. 2. Only the urethra has a mucous membrane, not the head of the penis. 3. Steve and I have been together for 10 years. I am HIV positive; he remains negative, and we have an incredible sex life. The kind most folks only dream (as in wet dream) about. We are both HIV specialists. We know and understand the risks involved, and take all the necessary precautions.

Stay well,

Dr. Bob



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