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To blow or not to blow...
Jun 29, 2008

Hello Dr. Frascino,

My partner recently tested positive and, along with dealing with the side effects of his meds, we are trying to figure out how to enjoy sex again.

I have always been a very oral person, be it in conversation or otherwise. My partner is terrified, though, to let me be... um, oral with him for fear of infecting me. He would prefer to wear a condom, but to me that is like having a conversation without using adjectives. If he is not one to have much if any pre-ejaculate and ejaculates outside, is this still rather risky? Also, sometimes after kissing him or fellating him, I get a medicial aftertaste. How could this be possible?

I would hate to forgo it all together. It is difficult in life to find things you truly excel at, which makes it doubly painful to give up. Thanks for any advice on how to make things as safe as possible!

Response from Dr. Frascino

Hello Mr. I-Can-Unscrew-A-Ketchup-Bottle-Cap- Using- Just-My-Tongue Guy!

Your partner only "recently" tested positive. Plus, he's having to deal not only with that new reality, but also with the side effects of medications! That's a lot to cope with. A period of adjustment is normal and to be expected. Perhaps the mere thought of putting you at any degree of risk is just too much for him to handle at the moment. My advice is to give your partner a little bit of space. He needs your support, not your demands for him to do something he doesn't feel comfortable doing at the moment. HIV can make even a sex god feel as though his mere touch is toxic! I can assure you that with time he will gain a better understanding of HIV-transmission risk and with that a better perspective on what's safe, safer and "safe enough." I would suggest both you and your partner read through the information in the archives, particularly the chapters "Magnetic Couples," "Sexual HIV Transmission" and "Oral Sex." Ultimately you need to establish sexual rituals that you both agree are "safe enough," based on what's known scientifically about HIV-transmission risk and your comfort levels. The boundaries of those rituals can change over time if you both agree to the new limits. Many magnetic couples have indeed decided the HIV-transmission/acquisition risk of oral sex is indeed "safe enough" for them to forego the latex play-suit. Others have decided flavored condoms are the way to go. Still others have waited until the poz partner's HIV viral load has been suppressed to undetectable limits on HIV medications, as we know this significantly decreases HIV-transmission risk. And others have enrolled in clinical trials of PrEP (pre-exposure prophylaxis). So as you can see, there are many options. Consequently, with a bit of patience and understanding, I'm confident the fact you have absolutely no gag reflex whatsoever won't go to waste, OK? Hopefully you'll soon be able to spice up your "conversation," whether or not "adjectives" wind up being used or not!

Dr. Bob



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