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How safe/unsafe is it?
Jun 23, 2006

Hi Dr. Bob,

I'm hearing that it's just not that dangerous to have some forms of unprotected anal sex (poz bottom/neg top).

I recently met a wonderful HIV+ man and am considering getting involved. He was in a 8 year relationship in which they always practiced condom sex when he was on top, and never when he was on the bottom. His partner never sero converted. Recently, he's been dating a neg man who never uses condoms when fucking a poz top. The risk is low, this perpetually neg man claims.

I have never practiced unprotected sex outside a monogamous relationship. But these anecdotes have me itching to try. My poz friend feels safe letting himself being the bottom without a condom, and always felt that he was protecting his partner, who never sero converted. Did they get lucky? Am I crazy?

Thanks so much for your time.

Response from Dr. Frascino

Hello,

First the facts: the estimated per-episode statistical risk of acquiring HIV from unprotected insertive anal sex with a person who is confirmed to be HIV positive is 6.5 per 10,000 exposures. That level of risk is significant and is exactly the same for each episode of bareback sex.

So did your buddy get lucky? Yes.

Are you crazy? Well, that's a relative term. The best I can do is advise you of your risk, based on the best scientific information we have to date. Is your "itch to try" so strong you are willing to accept this level of very significant risk? Personally, it's an itch I'd never dare scratch.

Dr. Bob



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