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mag Couple from New England with a second opinion question
Jul 20, 2006

Hi Doctor,

I hope its cooler in the Bay area than it is here in Beantown. If you ever visit here, let me know - we are a very liberal state!

Been with my partner who is positive for over a year now. He loves his ID doctor and I sometimes go with him to his visits. He is not on any meds his CD4 is quite high. When talking to his doctor he tells us that as long as we have protected anal sex we should avoid any real risk of virus tranfer. I am the "top" in the relationship, I always wear condoms - know how to use them from start to finish - and they have never broken. Since my partners viral load is high at times, I was wondering, sometimes I will go down on him, not in a deep throat manner but in a light manner and he does complete in my mouth. I have started using flavored condoms for this, but with his viral load high should I be wigged out by what I have done recently be dangerous? I am also an avid rimmer. His Doctor, one of the tops in the country and with a great sense of humor like yours tells me as long as I use condoms for anal we should be fine. And, make sure I limit any fluids in my mouth in terms of oral sex. He has advised us of PEP, should we have a condom break when I am having anal sex with him. BUT, he tells us it would be rare for a condom to break with lots of waterbased lube. I am just concerned that what I did in the past (a few weeks ago) didn't do me in. A second opinion I guess would be helpful!

I look forward to seeing you in Boston sometime soon. Bring Steve, me and my boyfriend will take you out for lobster!

Response from Dr. Frascino

Hi Beantown Boyz,

I absolutely agree with your stud-muffin's doctor! OK, now that we settled that, what time should we meet you guys at Legal Seafood? Or do you prefer McCormick and Schmidt's?

Guess I better add a few more comments or you won't let me order anything but a fired calamari appetizer.

Oral sex carries an extremely low risk for HIV transmission. This low risk is made even lower by not allowing your guy to pop his cork in your mouth and also if the viral load is suppressed.

As for rimming, there are no documented cases of HIV transmission from rimming to getting rimmed.

The PEP advice is right on target!

To sum up, your risk remains negligible. If you're worried, a rapid test at the three-month mark will relieve any residual fears and give a definitive result.

Actually, Steve and I get to Boston very frequently (three or four times a year). We're in New York at the moment and heading for Southern France soon.

I'm counting on you guys to keep the gay marriage laws on the books out there, OK? Now please pass the cocktail sauce.

Ciao!

Dr. Bob



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