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Possibilities of infection
Aug 5, 2004

My husband has AIDS. His vl is 2200 and his cd4 is 550. He refuses to wear a condom during sex and withdraws prior to ejaculation. What are the possibilities that I will/will not be infected with this method? We have been together 5 years and he has been infected for at least 12. He stopped using condoms because the lubricant irritates me and I did not want to have sex as often. I am really scared about getting infected but he keeps telling me that he knows what he is doing. When I insist, we fight. Help me please.

Response from Dr. Frascino

Hello,

Your risk of acquiring HIV from your HIV-positive husband is highly significant. Unprotected sex, even with "withdrawing before ejaculation", places you at extremely high risk. There is absolutely no question about that. In fact, you need HIV testing right away to determine if you may already be infected.

If your husband "refuses to wear a condom," you must refuse to have sex with him. Despite the fact "he keeps telling you he knows what he is doing," I can assure you he does not, unless what he's trying to do is infect you with the virus.

That lubricants irritate you should not be an impediment to insisting on condoms. There are a wide variety of water-based lubricants to try. You might also try the "female condom."

Here is what I suggest:

1. Stop having unprotected sex with your husband immediately.

2. You need HIV testing now to see if you have been infected already. If negative, you'll need follow-up tests at three and finally at six months from the time of your last possible exposure to definitively confirm you are HIV negative.

3. Insist on going with your husband to his next doctor's appointment with his HIV specialist and openly discuss this problem with him. I can assure you that the AIDS specialist will reinforce what I have written above and clear up your husband's very dangerous mistaken impression that he "knows what he's doing."

4. I sincerely hope you are still HIV negative, and if so, it's definitely worth the "fight" to remain so. If your husband continues to insist on placing you at risk, it's time to get out of that relationship and, if necessary, contact the authorities. He is, in essence, knowingly placing your life in danger, making you play "sexual Russian Roulette."

I urge you not to take any further risks.

Good luck.

Dr. Bob



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