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Hello Doc
Nov 11, 2006

Hi Doc

I just wanted to e mail you to tell you how much you have given me hope over the last 2 years since my boyfriend's diagnosis. I regularly read your responses to questions and your humour is so like mine I wet my pants sometimes! i just wanted to say hello and to encourage you to keep answering these questions as they benefit so so many people.

Hope you are doing ok and that you are staying well. My boyfriend is at a cd4 count of about 240 now so probably won't be long before he will have to start meds - he has fab docs here in the UK.

Could I just ask a small question ... He is more petrified of infecting me than I am and i wish he would have more sex!!! How do I persuade him?

Big Love to u xx

Ben

Response from Dr. Frascino

Hello,

You want help in persuading your boyfriend to have more sex? OK, sure, that's a challenge I should be up to. Ohhh wait, you want him to have more sex with you!?! Hmmm . . . well, OK, but that may be a bit trickier.

I'm assuming you are a magnetic couple, correct? When sex begins to fizzle rather than sizzle because HIV has become an unwanted intruder into your love nest, the main reason is usually lack of communication and fear of contamination. HIV can make even a sex god feel like his touch has now become toxic. Communication is the key. HIVers in magnetic relationships need to know you are both taking responsibility for maintaining your negative serostatus. He may be fearful you are willing to go further in your sexual repertoire than he feels is safe. I recommend you have a heart-to-heart discussion with your boy-toy away from the boudoir. Acknowledge both his and your worries about infection. Then create new sexual rituals based on what you both know to be safe and feel comfortable doing. This is called negotiated risk (or negotiated safety). Once you both agree on the safe boundaries of your lovemaking, all (or at least most) of the worry goes away. He'll realize you are equal partners in keeping you safe and HIV negative. Discuss also the "what ifs" and have a plan that includes either a starter dose of PEP or at least know how to access it quickly should a condom break or you have some other unanticipated significant exposure. If that doesn't work to heat-up your hottie, you could try couples counseling to better understand what his underlying fears might be.

I have other ideas as well, but those include props, like the latest porno DVD, a fine bottle of red wine, candles and a muscle-bound masseur named Buck. So I'd suggest you try the communication thing first.

Good luck!

Dr. Bob



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