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Concerned
May 9, 2008

Dear Dr. Bob, We were blindsided when my husband was diagnosed HIV positive almost three years ago. We have always had unprotected sex, and yet I am negative. He insists that he has never been unfaithful, and we continue to have unprotected sex regularly. He feels that if he does not ejaculate inside of me, then I am not at risk. As you can imagine, this deeply concerns me. My questions are, how can my husband contracted HIV if he was not unfaithful (I suspect that he was, but the HIV is punishment enough) and how on earth could I not be? We have young children, and I worry desperately for my health and theirs. My husband will not entertain the thought that this puts me at risk, because of the fact that we have never used protection and I am HIV free. He is doing fine on his medication- and his physician poo-poos any questions I ask regarding hows or whys. I feel very isolated and can only get information online because no one knows about my husband's condition except me and his physician. My own gyn. does not know. Can you please help me? Any information you can provide is greatly appreciated. -D.

Response from Dr. Frascino

Hello D,

Just because your husband "feels that if he does not ejaculate inside (you), then (you) are not at risk" doesn't make it true. In fact I can tell you categorically it is not true. You are indeed at risk of acquiring his HIV infection. Pre-cum (pre-ejaculatory fluid) contains active virus, which is very capable of transmitting the infection. I urge you to stop having unprotected sex with him immediately. Advise him: "no glove, no love." You'll need to repeat HIV testing at the three- and six-month marks. If you remain HIV negative at six months, you will have successfully dodged the HIV bullet.

How could you be HIV negative? As it turns out, not every exposure to HIV results in HIV transmission/acquisition (thankfully). Also, since your husband is now on medications, if his HIV plasma viral load is suppressed to undetectable levels, his chance of transmitting the virus significantly decreases. The bottom line is that so far you've been damn lucky. But you can't automatically count on that luck holding out any more than someone playing Russian roulette can relax after pulling the trigger once and not blowing his brains out. (It could happen on the next trigger pull!) Discuss your insistence on safer sex practices openly and forcefully with both your husband's HIV specialist and your gynecologist. Show them this post if it will help you broach the topic.

Regarding your husband's HIV infection, you are correct: It did not magically appear. He had to contract it from somewhere/somebody. I would insist he level with you. I would also encourage you widen your network of support to help both you and your husband. Take some time to read through the wealth of information on this site, its archives and related links. It might even be helpful for your husband to read it as well. We have a whole chapter in the archives devoted to magnetic couples. I should also point out I too am part of a magnetic couple. I would never consider putting the love of my life at risk for my personal pleasure. To do so is astoundingly selfish and morally reprehensible.

Good luck to you both.

Dr. Bob



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