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Confused about safe sex
Feb 7, 2005

My boyfriend informed me he is hiv positive. We have known each other for almost three years but havent had any sexual contact. I have been a supportive friend all this time but we are considering marriage. I have read all I can find but need it stated clearly. Will condoms used correctly prevent Hiv? What about oral sex? Should a condom be used. I have dental issues and this worries me. Can he perform oral sex without using a barrier on me? I have accecpted his status and havent changed in my feelings for him. But he is very concerned about my health. Thank you for your time. Btw, his doctor gave us your site address. He sends all his hiv patients to your. Thank you

Response from Dr. Frascino

Hi,

I certainly understand your desire for a clear "black or white" type answer to your questions; unfortunately the reality is that the answers are all in the gray zone. The best approach here is for both you and your fiancé to learn as much as you can about the potential HIV risk associated with various safer-sex methods. Then together you can create your own safer-sex rituals that you both agree on. You need to discuss what each of you feels and believes is safe or unsafe, based on individual comfort level in conjunction with whatever medical information we've been able to reveal so far.

Regarding your specific questions, here's what we know:

1. Condoms. HIV cannot pass through intact latex. No way, no how. So will condoms used correctly prevent HIV? I guess much of that depends on the "used correctly" part. And there is also the rare event of a condom breaking.

2. Oral sex. Oral sex carries a low risk for HIV transmission. Some magnetic couples have decided the risk is "acceptable" and do not use condoms or dental dams. Other couples find this to be unacceptable for their comfort level.

I'd suggest you read through the archives pertaining to magnetic couples. All of us (yes, even me and Steve (Dr. Steve in the Tratamientos Forum) have had to grapple with these concerns. Communication is key. If you haven't read the HIV Insite chapter on Safer Sex Methods, this would also be a good place to review the current scientific data associated with specific sexual practices and safer-sex recommendations. (http://hivinsite.ucsf.edu/InSite?page=kb-07-02-02)

Magnetic couples should also be aware of PEP (post-exposure prophylaxis). This should be readily available in case there is an accidental significant exposure condom failure, for instance.

Finally, I should mention magnetic couples can have very successful and satisfying sexual relationships. Steve and I have been together for 12 years and couldn't be happier. We hope the same for you and your poz mate.

Good luck. Remember Opposites Attract!

Please send your boyfriend's doctor my best wishes and thanks for referring his patients to this website.

Dr. Bob



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