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Overcoming phobia to sex (DISCLOSURE)
Oct 23, 2006

Dear Doctor,

First I must say reading your forum not only brings huge amounts of information, but a much needed smile, I am thankful for people like you!!!

The last year has been... eventful, let's say!

I found out I had AIDS on April (CD4 72 (8%) VL 48400. Being a healthy young man (33) this came a s a shock but I chose to fight and I decided that was a good Motto to live by. At the times I get down I push myself to remember all the people who at a situation like mine did not have a chance to fight like we do today. I spent three weeks in the hospital to take care of a list of oportunitic infections (From PCP, to candidiasis to several parasites) and the I started on Sustiva and Truvada. Four months after CD4 168 (14%) VL undetectable. Everybody tells me this is an excellent response including your colleage Dr Holodniy at this forum, so decided to trust they are saying the truth and continue fighting. Now I am back to my sport practicing (which feels liberating) swimming and running my daily half hour.

This weekend an event took place that I was fearing ever since April. A guy made a move on me and we kissed, I am not made of stone, and needed that a lot. The he asked me to go over his place... and I completely freaked out and said no. He was persistent, but I managed ot make my head direct the situation (not so sure about that now).

He was so persistent (good to see guys still want me at least :-) ) I ended up telling him... THE SECRET!!!!!!!!!!

He answered: "I hope you knew what you were doing when we kissed"

My answer: "Of course I did, but more important... YOU SHOULD KNOW TOO"

I am not too depressed abot that event... but it annoyes me to share such private information with someone I do not know (Many people who know me don't know) and get that kind of selfish response when my only intention was TO DO THE RIGHT THING. Have made any progress at all in our "united" gay comunity.

A good friend of mine, HIV positive, told me I should have not told him I had AIDS, as it is very private information adn as long as I am careful I don't need to do so. Is it normal to develop this kind of sex phobia after being diagnose? Do people overcome it? Did you have that problem? Maybe I am just weird... bu Ill keep fighting. Iknow you are busy people so if there are more important matters attend those... this is secondary. I'll keep reading you, as you have indirectly become a part of my life (mornings more exactly), and cosider you the friend I don not know.

By the way, quick question...Alkaline phosphatase is at 358. My doctor tells me not to freak as medication (Sustiva, Truvada, Spetrim Forte) is mos probably causing it but we arranged a check up in two months. I usually freak becasue I tend to believe people do not want me to worry and do not tell me tha enire truth (Overcoming that already). SHould I worry, or relax and continue fighting.

Best wishes from Danny-boy

Response from Dr. Frascino

Hey Danny-Boy,

I'm glad you decided to fight! You have every reason to be optimistic. I agree with Dr. Holodniy's assessment of your progress!

Regarding your elevated alkaline phosphatase, this is most likely a side effect of taking tenofovir, a component of Truvada. Without elevation of other liver function tests, your alkaline phosphatase is most likely originating from bone and not your liver. I agree it should be followed up with a repeat test within a month or two.

Finally, HIV disclosure! This is a tough topic that I've addressed many times in the past. There are no easy answers. I'll repost some of my comments from the archives in the hope that you'll find them useful.

Be well. Stay well.

Dr. Bob

Feel Really Bad Jul 12, 2005

Dr. Bob, I am an HIV poz male of five years, I try to make sure I have safe sex for the most part. I placed an ad, where it asks you if you are neg or poz, or you do not have to answer, I choose not to answer, and instead have that conversation with a person when sex is a possibility. However, I met this guy, we had dinner and a few glasses of wine, and I spent the night, however during the night he started to have aggressive sex with me that lead to unprotected sex, this is someone I do not know his status. I am a wreck, he stated he had diarrhea for a few days, and a pain in is throat, I was tested two weeks ago, have not had sex with one else, and don't have any std's... I know I have to bring this subject to the table, please help me out.. Jim

Response from Dr. Frascino

Hi Jim,

The subject of when and how to disclose your HIV status is not an easy topic to address, as there is no easy (or correct) answer for everyone's unique situations. Jim, I think you already know what needs to be done, and I would add the sooner the better. I'll post several of my responses from the archives that address the disclosure issue.

Good luck, Jim.

When to dislcose Mar 28, 2004

Hi Dr. Bob,

Thanks for your helpful insight for us pozitoids. I have been positive for a little over a year now. I have only dated one guy since and he was also positive. That lasted for about six months as I was not ready emotionally to be involved with someone so soon after my diagnosis. Well here it is a year later and I have met a great guy. We met at a club a few weeks ago. We have not had sex yet. We have however kissed passionately on several occaisions. I am going to be spending the weekend with him next week and it will definitely be time to perform. We have not even broached the subject yet of HIV. I am very interested in this guy and am wondering when I should tell him. I know it will be before we get in the sack. But I am wondering if it would be best at dinner, after dinner...This is the first time I have had to disclose to a guy since my diagnosis, not knowing what his status his, his feelings about HIV etc. (I met the guy I dated immediately after my diagnosis through a positive group). So I am totally new with this disclosure thing. Any insight you could give me about what to say and when to say it would be greatly appreciated. Your experiences as a fellow positoid are refreshing and greatly reasurring.

Thanks again.

Response from Dr. Frascino

Hi,

I recently posed the "when do you tell a potential bed partner you're positive" question to a group of pozitoids. The answers ranged from "pre-smooching" to "pre-heavy petting" to "before the money shot" to "afterward" to "I usually don't even tell 'em my name!" so, you can see, there really was no consensus here whatsoever! As for my personal opinion, I addressed this topic recently in another question, so I'll just re-copy that post and hope it helps your decision process. Good luck.

Dr. Bob

help,i feel like a deadly weapon Posted: Mar 18, 2004

Dear sir, several times i foloowed your forums and answers you have given to many other people here. I'm really in crazy mood and i beg you tell me something about the follow situation.I'm very sad because after 1year and a half of non sex (i've been teste poz 1 1/2 year ago) i have found a guy that a really like. I had sex with him and, protected anal sex, but we have kissed (we liked very much to kiss each other) but i was streesed about the risk. Secondly,i let him make me oral sex for 1,2 min. What is worse is that we like each other very much and i think we've just falling in love (i didn't disclosed my status). I have such bad feelings and i'm scared for him. What are the risks for him to become +? i know, there are different opinions but could the kiss be such a risky way and is it so risky that i let him 2 min to provide oral sex, i didn't come into his mouse ( i interupted him because i was scared for him) . Sorry for the language. i'm from an eastern country and i cannot find here too many advices. As you can imagine i care so much about him that i'd rather be dead than to hear that he become infected. Please, i would be grateful if you could find 1 minute to answer me. Kindly yours,

Alex

Hello Alex,

First off I must remind you and our readers that questions like these should be posted to the Safe Sex/HIV prevention Forum, not the Fatigue and Anemia Forum. I'll post this reply in both forums, but folks if you've asked a question here not related to Fatigue and Anemia, I'd strongly suggest you re-post to the correct forum to increase your chances of a reply. Thanks! OK, now back to your question. I'm glad you didn't "come into his mouse" as many mice aren't very happy about getting their tonsils spunked. Sorry I don't mean to make light of your situation. I'll be serious now. To disclose or not to disclose, and exactly when to do so are very difficult questions for us HIV pozitoids. Some folks live by the "don't ask, don't tell" rule, but always play safe. Unfortunately what one person considers "safe," someone else might consider too risky. Some folks prefer the "do ask, do tell" philosophy. Sure, this may result in getting dumped before you get humped, but wouldn't you rather know sooner rather than later that this guy is never going to be your Mr. Right? I know you are from an eastern country, but I thought I would mention that here in the US, 24 states have passed HIV-specific laws regarding disclosure. Merely exposing someone to HIV you don't have to have actually transmitted the virus can land you in jail! So in these states, as long as you know you're HIV-positive, you can be arrested just for having sex and not disclosing. These laws, as you can imagine, are extremely difficult to enforce. OK, regarding the risk of HIV transmission in your particular situation, kissing is not considered a significant risk. Oral sex carries an extremely low risk. Alex, at this point, I would strongly suggest you be honest with your new boyfriend. Waiting longer is not going to make things any less awkward. His response may surprise you, and could range from a caring heart-to-heart discussion to a cranial meltdown and wall-punching. Hopefully, he won't say either "See ya later" or "What's HIV?" also, it's probably worth noting that at this point, you don't know your boyfriend's HIV status either. It's possible he too may be positive. At any rate, if the relationship does end because he can't accept your positive status, please realize the guy is rejecting the virus, not you! Good luck,

Alex. Dr. Bob

How and when to tell a boyfriend im hiv+ Jan 20, 2005

I have just found out i am hiv+. I am already informing past and present sex partners of this so they can be make sure they are alright. One of these guys I believe could be "the one" ive been looking for. How do I tell someone of my status and how do I deal with being rejected solely on me being hiv+?

Response from Dr. Frascino

Hi,

Sorry to hear about your recent positive diagnosis. There are no easy answers as far as exactly when and how to disclose your HIV status to your sex partners and to "the one." There are various strategies to consider, some of which I've discussed in the archives. The one strategy that I certainly don't recommend is waiting months and months to break the news. I don't believe good relationships withstand such secrecy. Consequently, I'd advise disclosing all to your honey now. If his/her status is different from yours, there are a variety of common immediate reactions that might ensue, including:

1. a caring heart-to-heart with lots of hugging and perhaps a few tears

2. "What's HIV?" (most likely if you are dating a graduate of an abstinence only sex education program)

3. a cranial meltdown and wall-punching

4. silent shock and awe

5. "See ya later." (most likely if you are dating one of those compassionate conservative Republicans)

Let's hope it's #1, but even if it's #5, just remember they are rejecting the virus, not you! Perhaps some advice form Buddha is in order (and isn't it always?): Asked how he braved his critics' insults and anger, Buddha replied, "If someone offers you a gift and you decline it, to whom does the gift belong?" I'm a bit less contemplative. If someone blows a load of rejection your way because of your HIV status, I say, "Spit, don't swallow." I wonder if I can put all that on a fortune cookie fortune?!?

Good luck! I'm here if you need me.

Dr. Bob



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