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Safety of Oral Sex
Mar 9, 2008

Doctor, I know you've probably had this question a million and one times before but here I go. I've been recently diagnosed positive, my partner is negative. He's always enjoyed orally pleasing me and very often swallowed. I know the swallowing is no longer a good option, but is the very act of taking me into his mouth putting him significantly at risk?

Response from Dr. Frascino

Hi,

Yep, this question "comes up," so to speak, often in magnetic relationships. And yes, I have addressed the topic before. (See below.) I really don't have anything new to report, other than to note that if your HIV plasma viral load is suppressed to undetectable levels with antiretroviral therapy, your risk of transmitting the virus during sex to your partner is dramatically reduced. Many magnetic couples are now employing this strategy for an extra degree of protection and harm reduction. I'll reprint below some information from the archives to address your primary concern about oral sex. (There are many more posts in the archives discussing this issue as well. Have a look!)

Good luck to you both.

Dr. Bob

poz/neg oral sex Nov 19, 2007

I am poz and my boyfriend is neg. I am undetectable. Is it safe for me to perform oral sex on him with no condom? Is it safe for him to perform oral on me with no protection? I want to keep him safe. Thank you.

Response from Dr. Frascino

Hello,

The real question is how one defines "safe." From your post I don't know if you are a gay or hetero couple, but one thing is clear: you are a magnetic couple (one poz and one neggie). What you and all magnetic couples must do is decide what sexual activities are "safe enough" for the two of you, based on what is know scientifically about the transmission-risk potential of various sexual activities and your individual comfort levels. I have been in a magnetic relationship with Steve (Dr. Steve, the expert in The Body's Tratamientos forum) for 15 years. What we as a couple may decide is safe enough and within our comfort zone may not work for you and your partner. Only the two of you can decide that. I can advise you that oral sex in general carries a very low risk for HIV transmission. However, that risk is not completely nonexistent and there can always be extenuating circumstances that might increase the risk of transmission, such as trauma in the mouth or concurrent oral STDs, etc. My advice is that both you and your partner read the information in the archives related to "magnetic couples," "HIV transmission," "HIV prevention" and "safer sexual practices." In addition you should review the scientific information about HIV-transmission risk. A summary of this information can be found at http://hivinsite.ucsf.edu/InSite?page=kb-07-02-02. Following this you'll need to develop your own "safer" sexual rituals that you both agree upon.

Good luck.

Dr. Bob



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