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The Neg Guy
Oct 13, 2003

I am curious what are the chances of contracting HIV by barebacking a POZ bottom. I had no open cuts on my penis when I had sex with my partner. If I continue to have un-protected sex with my poz partner who is a bottom. Does it increase the possibility of me contracting it, if I am strictly a top.

I am also curious why many POZ gay men feel that they don't have to use a condom because they are POZ. Do you feel the reason could be that they lost all respect for themselves? I find it irritating when you meet someone who is POZ and they would rather bareback then have enough respect for me (the neg guy) who would like to use a condom.

Thanks for your help. B.K.

Response from Dr. Frascino

Unprotected sex, top or bottom, male or female, gay or straight, places you at risk for STD's, including HIV. The statistics we have are for the receptive (bottom) partner. They indicate up to a 3 percent per episode risk for unprotected anal sex with a partner known to be HIV-positive. Since you are the insertive (top) partner, your statistical risk would be somewhat less, -- but still very significant. Each episode of unprotected sex carries the same statistical risk. So, Top Guy, let me give you the "bottom" line: If you want to stay Neg, wrap your Mr. Happy each and every time you go out to play. Also, since you have already had significant risk, HIV testing is warranted and strongly recommended for you 3 months or more after your last possible exposure.

Why POZ gay men choose to bareback is a highly complex topic. Some have the unfortunate misconception that since they are already POZ, there is no potential downside for them. They may assume that since it takes two to tango, staying safe and or neg is the other guy's problem. Aside from being incredibly irresponsible towards one's sex partners, this philosophy also places the POZ guy at risk for secondary infection with a more aggressive strain of virus. Secondary infection is now well documented.

Have POZ barebackers lost respect for themselves? Perhaps. That's a philosophical discussion that has much to do with self-image, misguided anger against being POZ, reluctance to disclose or discuss their status for fear of rejection, etc., etc., etc. I've moderated some very interesting discussion groups with POZ guys only wanting to date or have sex with other POZ guys, Neg guys refusing to date POZ guys, or magnetic couples trying to come to grips with what level of risk they are willing to accept in their sexual rituals.

Neg-guy, ultimately you must take responsibility for your own health. Assume all sex partners are potentially HIV-positive and use appropriate protection. The message to POZ guys is exactly the same.

Stay well. I mean that Stay well!

Dr. Bob



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