Hi, Dr. Frascino. Have a question for you...

For the past few years, I was gambling more and more on the fact that my sole sexual activity -- insertive anal intercourse -- was lower risk than receptive anal intercourse. I started using condoms less and less. Obviously, I gambled and lost. After almost twenty years of regular biannual HIV testing, I tested positive last November.

Now I'm faced with trying to figure out how to live my life, sexually speaking, from this point forward. And I'm realizing there's no shortage of poz bottoms out there who want to have unsafe sex with poz tops like me. Their POV seems to be that they've already gotten it, so why not live life the way they want to?

On one hand, I find this outlook very tempting and would love to continue to have the kind of sex that feels most natural and satisfying to me, but on the other hand I want to do everything I can to minimize my future health risks and maximize the time I have left.

There seems to be a lot of debate going on about re-infection and super-infection, and I'm interested in your take on the subject.

Thanks, D

Hi D,

Re-infection and super-infection have now both been well documented. The question remains as to how often this occurs. However, now knowing that it does actually occur and can be easily prevented, are you willing to take the risk? I'm certainly not. You are living proof that tops can become infected. So if a positive bottom has a very aggressive, highly resistant strain of the virus, the consequences of your acquiring that strain can be catastrophic. Only you can decide what level of risk you are willing to take. All I can do is let you know the risk is real, very significant, and potentially devastating. Check the archives for additional details about re-infection and super-infection.

Dr. Bob