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HIV+ being Selfish (MAGNETIC COUPLE CONCERNS 2008)
Jul 7, 2008

My first love told me after we got back together after 3 yrs of separation he has had HIV for 2 yrs.. i cried for weeks... the thought of losing him was horrible. I was scared to get tested even though i hadnt had sex with him in 3 yrs but i got my test and its negative, i had a break down and i quit talking to him, writing him .. or anything.. i felt bad and one day i wrote him and told him i just couldnt do it. i couldnt risk everything.. i couldnt die for love as so many would.. well he wrote back and said risk what? i need to educate myself more and study more about it.. he acts as if we can go on living life like he doesnt have it.. i feel as if my heart has broken.. we were going to get married and everything.. but who's to say one day were having sex and the condom breaks or it slips off.. wth.. and i contract it.. thats my worst nightmare.. i feel he's being selfish.. like its nothing, but deep down he knows it is.. i love him, and i would love to be with him.. but how else could we be 120% safe while having sex?

Response from Dr. Frascino

Hello,

I find your logic and actions a bit confusing. When you found out your "first love" was HIV positive you "cried for weeks," because "the thought of losing him was horrible." However, once you found the courage to get tested yourself and determined you were negative, you decided to "quit talking to him and writing to him!" Hmm . . . so you deliberately ditched the guy you were so afraid of losing???? That doesn't really make much sense. You state you did this because you "couldn't die for love as so many would"??? WHAT??? Don't you think you are being a bit overdramatic? I certainly think you are. Being part of a magnetic relationship is not equivalent to hari-kari or jumping off the Golden Gate Bridge! Your boyfriend advised that you need to educate yourself about HIV-transmission risk and I couldn't agree more! He was not suggesting you" go on living like he doesn't have it." Rather he was suggesting you learn how to go on living life safely together, knowing full well that he is HIV positive and you are negative!

Is it possible that a condom could fail (break or slip off)? Yes, it's possible, although with proper use this would be an extremely rare occasion. If it did occur, there are measures that can be taken to help avoid infection, including the use of PEP (post-exposure prophylaxis). There are other ways to decrease HIV-transmission risk. For instance, if your boyfriend takes HIV medication and drives his HIV plasma viral load down to undetectable levels, the risk of HIV transmission decreases significantly. There are also clinical trials underway for PrEP (pre-exposure prophylaxis). This involves the HIV-negative partner taking an HIV medication to prevent transmission. You can read more about all these issues in the archives.

You report you think your boyfriend is being selfish. Hmm . . . that's not the way I would assess the situation. Rather, I think he's being perfectly reasonable. You, on the other hand, are being irrationally fearful. You report you love him and would love to be with him. If this is indeed the case, that option is certainly open to you. No one can promise 120% safe sex, because obviously 120% of anything doesn't exist. I would suggest you follow your boyfriend's advice. Get better informed about HIV-transmission risk, HIV prevention and safer sexual techniques. A good place to start is by reviewing the information in the archives of this forum. We have whole chapters devoted to those topics. Also, read through the chapter on magnetic couples (one positive, one negative). Can magnetic relationships really work and be sexually satisfying? From personal experience, I can assure you the answer is absofrickinlutely! I have been in a magnetic relationship with my partner Steve (Dr. Steve, the expert in The Body's Tratamientos forum) for almost 15 years and counting! I am HIV positive; he is negative. We continue to have phenomenal sex. I would urge you not to push Mr. Right away for all the wrong reasons! I'll reprint below a small sampling of the information in the archives relating to this topic.

Dr. Bob

How do I ask him why his sexual beahvior towards me has changed? Jun 5, 2007

Hello there!

I have been dating this person for more than a year now and during the dating period I found out I was positive. When I met him I shared with him my last results as he shared with me his which were both negative. We proceeded to engaged in safe sexual activity and it was amazing, but two months into the dating it was about the time to get my routine test with the results coming back positive. I immediately notified him and even though I knew our sexual activity was safe, I recommended for him to get tested. He did and his status up-to-date is negative and hes gotten tested 3 times, so I guess that make us a serodiscordant couple.

There has been a dramatic change when it comes to intimacy from him towards me, a complete change from when we met; it changed when I told him the results of my test. He says he feels comfortable and that he has no issues with it, but when it comes to intimacy, lets just say that it comes from me to him only and it ends there. I do not remember when was the last time he touched me in an intimate way, and cant help but think that he is probably afraid of doing anything that he thinks will put him at risk. The most I get from him are kisses and hugs. I really, really like this guy and even though I have mentioned many things about HIV/AIDS, mentioned to him that I will never put him at risk, and asked him how comfortable does he feel, I just do not know how to approach him and ask him why he is treating me like someone who gave up sex, like someone who is just there to give and that is it, why he doesnt even erotically touches me?

As a test, last time I was being intimate with him I suggested he pass me a condom and even though he agreed and passed me the condom and all the necessary things, his actual physical reaction was other, it changed from having an erection to completely lost it, and I didnt even open the condom, just the thought of what was coming next made him loose it, and for me that was proof of how uncomfortable he is feeling with that, and it hurt. So, how do I approach him with these questions? Or is it me that do not want to do it because of fear or knowing the answer? I have asked him many times generally and I think that if he is intelligent enough, which he is, he knows what I am talking about. I need advise!!

Thanks!

Response from Dr. Frascino

Hi,

There is no doubt you and Mr. Right have a problem. Your positive HIV test spoiled his vision of happily-ever-after. The problems your relationship is facing are not uncommon for magnetic couples (one poz, one neggie). The good news is that he hasn't decided that you are no longer compatible and ended the relationship. The not-so-good news is that he's not really dealing with the issue very well.

My advice is that you (and hopefully your boyfriend too) read through the archives of the Safe Sex/HIV Prevention forum pertaining to magnetic couples. Communication is key. Couples counseling may be helpful in getting your partner to open up about his feelings and confront his fears. He may feel he can't discuss certain fears with you because you're the one actually dealing with being positive.

With open communication and the establishment of sexual rituals you both agree are safe (or "safe enough"), you can have a very successful and satisfying relationship. I speak from experience, as I'm part of a magnetic couple (with Dr. Steve, the forum expert in the Tratamientos forum). We've been together for almost 14 years now and still have toe-curling, own-name-forgetting, wake-the-neighbors type of sex.

Ultimately, if your relationship doesn't work out, remember your boyfriend is rejecting the virus, not you! Your ultimate Mr. Right needs to fulfill your needs and desires and accept you as "virally enhanced."

Good luck.

Dr. Bob

How do I ask him why his sexual beahvior towards me has changed? Jun 5, 2007

Hello there!

I have been dating this person for more than a year now and during the dating period I found out I was positive. When I met him I shared with him my last results as he shared with me his which were both negative. We proceeded to engaged in safe sexual activity and it was amazing, but two months into the dating it was about the time to get my routine test with the results coming back positive. I immediately notified him and even though I knew our sexual activity was safe, I recommended for him to get tested. He did and his status up-to-date is negative and hes gotten tested 3 times, so I guess that make us a serodiscordant couple.

There has been a dramatic change when it comes to intimacy from him towards me, a complete change from when we met; it changed when I told him the results of my test. He says he feels comfortable and that he has no issues with it, but when it comes to intimacy, lets just say that it comes from me to him only and it ends there. I do not remember when was the last time he touched me in an intimate way, and cant help but think that he is probably afraid of doing anything that he thinks will put him at risk. The most I get from him are kisses and hugs. I really, really like this guy and even though I have mentioned many things about HIV/AIDS, mentioned to him that I will never put him at risk, and asked him how comfortable does he feel, I just do not know how to approach him and ask him why he is treating me like someone who gave up sex, like someone who is just there to give and that is it, why he doesnt even erotically touches me?

As a test, last time I was being intimate with him I suggested he pass me a condom and even though he agreed and passed me the condom and all the necessary things, his actual physical reaction was other, it changed from having an erection to completely lost it, and I didnt even open the condom, just the thought of what was coming next made him loose it, and for me that was proof of how uncomfortable he is feeling with that, and it hurt. So, how do I approach him with these questions? Or is it me that do not want to do it because of fear or knowing the answer? I have asked him many times generally and I think that if he is intelligent enough, which he is, he knows what I am talking about. I need advise!!

Thanks!

Response from Dr. Frascino

Hi,

There is no doubt you and Mr. Right have a problem. Your positive HIV test spoiled his vision of happily-ever-after. The problems your relationship is facing are not uncommon for magnetic couples (one poz, one neggie). The good news is that he hasn't decided that you are no longer compatible and ended the relationship. The not-so-good news is that he's not really dealing with the issue very well.

My advice is that you (and hopefully your boyfriend too) read through the archives of the Safe Sex/HIV Prevention forum pertaining to magnetic couples. Communication is key. Couples counseling may be helpful in getting your partner to open up about his feelings and confront his fears. He may feel he can't discuss certain fears with you because you're the one actually dealing with being positive.

With open communication and the establishment of sexual rituals you both agree are safe (or "safe enough"), you can have a very successful and satisfying relationship. I speak from experience, as I'm part of a magnetic couple (with Dr. Steve, the forum expert in the Tratamientos forum). We've been together for almost 14 years now and still have toe-curling, own-name-forgetting, wake-the-neighbors type of sex.

Ultimately, if your relationship doesn't work out, remember your boyfriend is rejecting the virus, not you! Your ultimate Mr. Right needs to fulfill your needs and desires and accept you as "virally enhanced."

Good luck.

Dr. Bob

Entering into a mag relationship - any sound advice? Dec 23, 2006

Hi Dr. Bob,

Been dating a guy with HIV for a month now. Great guy, handsome as hell, sweet, etc. He has had HIV for many years but is not on meds. High CD4 but his viral is a bit high. I am the top, we use condoms for anal sex. no issues there..lube is our friend. I sometimes go down on him...no cum in my mouth and I will rim him before anal sex. Am I really put myself at risk? He tells me his ID doctor said we should be fine. But I wanted to see what you think? Also, how often should I be tested? I am guessing it would be highly unlikely I would get infected with what I am doing. As, I always have assumed my partners are pos when having sex with them.

Nantucket Couple in LOVE and HAPPY!

Response from Dr. Frascino

Hello Nantucket Lovebirds,

Congratulations on your new romance. Opposites do attract! As for sound advice, I suggest you read through the entire section on magnetic couples in the archives. There you'll find a wealth of information as well as my personal views on staying safe within a magnetic relationship. Communication is key! You both need to agree on what level of risk is acceptable to you and set your boundaries there. We call this negotiated risk (or negotiated safety). Condoms for anal sex are obviously a must. Unprotected oral sex is something you'll need to discuss. The HIV risk is extremely small, especially out ejaculation or extenuating circumstances. But a risk, however slight, still remains. Many magnetic couples have decided this level of risk is acceptable. Regarding rimming, there are no documented cases of HIV transmission from rimming or getting rimed. However, other STDs can be readily transmitted this way. (Check the archives for details.)

Once you and your partner have reviewed all the information about risk associated with various sexual activities (again the archives are an excellent source for this information), you should develop your own safer sex rituals based on what you both feel is acceptably safe. If an unanticipated exposure occurs, be ready to begin PEP ASAP. Your boyfriend's HIV specialist should be able to help with this.

How often should you test? Again, it's up to you, but general guidelines would suggest very six to twelve months.

Finally, I should mention Steve (Dr. Steve, the expert in The Body's Tratamientos forum) and I are also a magnetic couple, presently celebrating our 13th year together. If you guys are even half as lucky as we've been, be prepared for pleasures and passions beyond your wildest imagination. Perhaps 13 years from now we'll have a new limerick:

There once were two hotties from Nantucket, Who played safe every time they would . . . .

Be well. Stay well. Happy Holidays.

Dr. Bob

Mixed couple advice!! Aug 29, 2005

For the first time I am in a consitant sexual situation with someone who is not HIV+ although I am. To date I have been the bottom in this scenario and we have always used a condom however, things have been hot and heavy at times with slight penetration. How at risk is my partner in this situation and do you have advice for a "newbie" to help keep both of us safe, sane and happy... sexually and mentally??? Any and all advice would be great!!

Response from Dr. Frascino

Hi,

Welcome to the wonderful world of magnetic couples! I would start by reviewing the information in the archives of this forum and related links pertaining to magnetic (serodiscordant) couples. I'll post just one of many below.

You and your new stud muffin need to firmly establish your own unique safer sex rituals that you both agree are both "safe and safe!" You should do this sometime other than in the midst of a toe-curling, hot-and-heavy session. Once you've agreed on your rituals, stick to them and remember PEP is available for unavoidable/accidental significant exposures. Once this groundwork is set, I'm confident you'll both be both happy and satisfied!

Good luck!

Dr. Bob

Safe sex help.. one magnetic couple to another! posted Dec 13, 2004

Hi Dr. Bob,

Fist off, Id like to thank you for all of the valuable support and information that you and The Body contribute to concerned people such as myself. The issues dealt with here can be quite traumatic its a relief to know there are people like you out there trying to make a difference.

Though Ive done a lot of reading on this site in the last year, Im a first time responder. As I do a LOT of reading about HIV (too much at times), I consider myself fairly well informed on the topic. But now Ive come across a situation that Im struggling with and Im hoping you can help (especially considering your personal situation). Im posting in this category as I would like to make sure and get your take on the subject. It deals with starting a magnetic relationship and as youre in a successful one yourself, Im VERY interested to hear from you.

A little background Last October I was diagnosed HIV positive and according to my doctor (who is luckily both gay and an HIV specialist) it was detected quite early. Id always been quite concerned with contracting HIV so after any risky behavior, I would always follow up with tests and lots of questions. Needless to say, my luck ran out.. but thats a whole different story. Anyway, so he concluded an early infection because my antibody test came back negative and my RNA test came back positive. Then within 2 weeks they both came back positive. After a crash course on HIV and therapy options, I decided to go on HAART (Combivir & Viramune). My Dr. didnt push me into a decision, but said that (at the time) there was an untested theory that drug therapy at such an early stage may have significant benefits down the road (but again thats another subject.. I promise I have a valid question). As for my levels my initial tests were 240,000 viral / 450 T4 and as of my last test my viral is less than 50 and my T4 is 475. Ive been undetectable since January 04 and my T4 has been a rollercoaster between 375-700. Before becoming positive, I was nearly paranoid of HIV and intimate contact with positive people, so you can imagine it was quite an adjustment. I think Im doing well so far and have become much more comfortable and educated. I was also fortunate to have some good friends and a sex buddy who were all negative but experienced with HIV positive people. (The question is coming I promise!) After some adjustment, I started to get back to normal which, for me, included hook-ups. The sex buddy I had at the time helped me get back into the swing of sex and showed me how to do it safely. Once things fizzled with him, I took my newfound knowledge and comfort level and moved on.

I ended up hooking up with a new guy several times without disclosing my status. I was under the impression (at that time) that as long as I kept things on the safe side, that it was okay not to disclose. My reasoning behind that was rather complex and I wont delve into it here, but what is important is that as I got to know him, I realized that I should have told him from the start. Ive since sat down with him and explained my status and all it entails and answered all his questions. It turns out that he was quite like me before I was positive in that hes terrified of HIV and intimate contact with a positive person. It also doesnt help that an HIV infection would seriously hinder the future of his life-long profession (for privacy reasons youll just have to trust me on that one). He was upset, but weve managed to work through a lot of the issues. I took him to see my specialist and hes passed 2 RNA tests and an antibody test. Also, I think its noteworthy that all of our sexual encounters fall under safer sex (condoms, no semen in the mouth/ass, etc.). Since I told him, we have restrained from any sexual activity that isnt considered extremely safe (ie mutual masturbation, kissing) As gay relationships can often be a bit unconventional sometimes, were now doing the whole getting to know you thing and have taken quite well to each other. Weve literally talked for hours on end nearly every day for over a month and are very open and clear. Hes made sure to clarify that it is the HIV that he is afraid of and not me as a person. Weve also mutually agreed that minus the HIV issue, wed be interested in starting a relationship. My question is this What exactly is considered safe sex? I have a few particular situations Id like to run past you regarding discordant or magnetic couples because it seems there either really isnt a lot of information out there pertaining to our situation or that its all conflicting. We have both read so much on the topic that our brains are about to burst, and weve gained very little helpful knowledge. Besides asking my specialist, Im not quite sure where to turn with this. I very much like this guy which says a lot as Im usually quite picky. Were compatible in every way I can think of so far, and its rather aggrevating that something that seems out of my control is whats standing in the way. Heres our situation Hes negative and a total top, Im positive and 99% bottom. So there would be no problems with sticking to those roles, and were both fine with using condoms. He likes to occasionally suck me (without ejaculate) and I would be interested in regularly sucking him sometimes with ejaculate (swallowing). Considering our roles, Im finding very little information on the insertive partner being negative and what risks are posed to him with a positive receptive partner. According to posts Ive read from you, the porous condom theory is false. So is it advisable to assume that there its safe for him to penetrate me with proper condom usage? If so, then does style or thickness of the condom factor in? I of course only use undamaged, unexpired name brand condoms, but Ive never seen data on thickness. And not to doubt you, but there seems to be a lot of talk about condoms being porous, but even in that talk its all focused on a positive top with a negative bottom. It seems no one talks about the risk of HIV passing from the bottom to the top during protected anal intercourse. Reason would tell me that under normal anal sex (no blood) the risk to a negative top from a positive bottom would be signifigantly less than if the roles were reversed. Also, all the data on oral sex Im reading focuses on positive insertive partners and never touches on the exposure risks involved in a positive person giving a negative person head. Again I would assume that the risks in our situation would much less as saliva is a very weak conductor of the virus. Ive also found very conflicting information regarding the risks of rimming (both ways). Basically the only thing considered safe that we can find evidence to back up is mutual masturbation and kissing, and its even iffy on the kissing topic. Recently my partner has had a throat infection which left him with a raw throat and tonsils. All the data were finding on HIV in saliva and kissing risks is all over the board. Were both agreed that we can be somewhat flexible sexually and are just looking for some concrete data to base our decisions on. I knew going into a relationship with HIV on the table would be difficult and require a lot of talking and mutual guidelines, but its proving to be quite maddening. I fear that before were ever able to find information that were comfortable making our safe sex decisions with, that well get so frustrated (mentally and sexually) that well be forced to give up. I would VERY much appreciate your input on the topic, especially given your experience with a magnetic relationship. Ive been asking friends, reading on the internet, and searching for books on the subject and were both planning on asking extensive questions on our next Dr.s appointments. Weve even considered trying to find a counselor on the subject, but it seems the Bush-era has pulled the rug out from under our citys major HIV organization.

I thought the hard part of a relationship involving HIV would be being open and honest (which was difficult at first), but what has proved harder is finding information that I can trust to make an informed decision.

I really hope youre able to help and that your advice can not only help us, but help the many other discordant couples that must exist out there! This guy is awesome and has been AMAZING with dealing with and helping me deal with HIV in our relationship. I refuse to let a lack of information on HIV get in our way.

Lastly, as I find your input valuable, I do not discredit Dr. Remien and would also be pleased to hear his input on the subject. Its just that (as it often is with traumatic situations) I also want to hear the voice of someone who is going through the same thing.

Sorry for the HUGE email, but like with this relationship I feel that openness and clarity are paramount.

Sincerely,

Frustrated

Response from Dr. Frascino

Hi Frustrated,

Dude, we've got to work on editing and focusing your comments and questions. When I saw the length of your post, I started searching Amazon.com for a Cliff Notes' version . . . .

First off, I suggest you do some searching too. Search the archives of this forum, as I've written many times about magnetic couples, risk and many of the subjects you pose in your question. Neither my opinions nor the scientific facts supporting them have changed. Now "briefly" turning to your direct questions:

1. What is safe? I suggest you review the information on Safer Sex at the HIV InSite Knowledge Base Chapter that can be found at http://hivinsite.UCSF.edu/InSite?page=kb-07-02-02.

With this information, you and your partner will need to realistically draw boundaries for your individual sexual rituals. This is called negotiated safety (or negotiated risk), and involves an analysis weighing what you both believe is safe based on individual comfort level and the medical facts. Communication is key.

2. HIV transmission risk is always greater for the receptive partner.

3. HIV cannot pass through intact latex with "proper condom usage," no matter who is on top. I have not seen scientific data that "style or thickness" of the latex condom really offer significant advantages as far as HIV transmission is concerned. However, if you feel better with the maximum strength/maximum thickness varieties, you should use them.

4. Regarding condoms being porous, let me reassure you that HIV cannot pass through intact latex.

5. Yes, the Bush Era is having disastrous consequences on HIV prevention education. Your local HIV specialist should be able to give you some leads on local HIV-competent and compassionate counselors.

6. Remember PEP is an option in case there is an accidental significant exposure. Also watch for information and results from a clinical trial using a single anti-retroviral agent as a form of prophylaxis against infection.

Finally regarding your "HUGE" e-mail, just in case you write back, remember sometimes less really is more.

Good luck.

Dr. Bob

Relationship Question sero-discordant couple Sep 26, 2004

Hey Dr. Bob...welcome home! Hope you had an awesome time in Paris.

My question falls out of the normal stuff in this forum, but I'd consider you more of a valid resource since you have 1st hand experience in this area.

I tested poz back at the end of June. Its been a roller coaster ride to say the least these 1st few months. Things have slowly started to fall into place and I'm not so obsessed with my diagnosis. I had been seeing someone pretty seriously up until about 2 months before testing poz. He was one of the 1st people I contacted as we had a few higher risk sexual situations which were legitimately something to be concerned about for his sake. After being told that i was the lowest most vile person for putting him at risk for this he promptly dropped out of my life. Thats a whole side story in itself but i won't go into it.

I was left feeling very hurt/angry/guilty regardless of the fact that i knew we had both been consenting adults in the risky things we did. Flash forward to a couple weeks ago. Out of the blue i got a call from him, proclaiming that he has passed the period to consider his negative test conclusive. Major relief for me. But he also is now alluding to wanting to give this another go with me.

I was nuts about this guy. I had a connection with him that i hadn't felt with anyone in quite awhile and was really hurt when things started to get difficult prior to my diagnosis. We've been talking alot again since he gave me his good news and I sense that he is true in his feelings, but at the same time he makes alot of assumptions about how i am dealing with being a person living with HIV. And if i hear one more time that it's "a manageable disease like diabetes" i think i'm gonna scream. Yes its manageable but no its not like being a diabetic.

Anyway, to cut to the chase, I'm scared to death about getting involved with someone neg. I think most of my fear lies with concern of infecting him. But it also has to do with a neg. person never really understanding what goes on in the mind of a poz person. If i may be so bold to ask, were you ever in a position where you didn't want to deal with neg. guys because it was just easier to date other poz men? Did this issue ever present itself with you and Dr. Steve in the begining? And if it did how did you two work through this/continue to work through this? Life is complicated enough without me having to be a teacher to someone about what an HIV+ person lives with. To top that off i've already gone on a couple dates since being diagnosed where the other guy was neg. and he made me feel like HE was doing ME a favor by consenting to go out with someone "sick". (total bulls**t). I don't need that again.

Please give me some encouraging words and possibly some good resources to reference that might address magnetic relationships! I trust your opinion and insight as a gay man who has been living with this scenario. BTW, why don't they have you answering questions in the mixed status couple forum?

You're the best and i think you have the patience of a saint to answer all of the nervous nelly "i know what you say-but i KNOW i have it" questions. Makes for interesting reading for sure!

Keep up the good work, and if you are ever in Chicago the drinks are on me :)

Dave

Response from Dr. Frascino

Hello Dave,

Yes, the "it's a manageable disease like diabetes" mantra can get a bit annoying, but it's not really as bad as the "I could get hit by a bus walking across the street" line. I mean after all, someone dies of HIV every 10 seconds. How the hell many bad bus drivers do they think are out there anyway???

OK, on to your question. Is it easier for poz guys to date only other poz guys? I certainly have talked to a number of pozitoids who are indeed "viral-centric." They want someone who's already been there, done that, and who is more likely to do them! And certainly we all know neggies who in their online ads include "must be bug free" or some other equally insensitive comment. But really Dave, how many Mr. Rights are there really out there for each of us? In nature, isn't it opposites that attract? As for a neggie never really understanding what goes on in the mind of a poz, well yes, I understand your concern, but couldn't that apply to just about any two people? A radical fairy could date a Log Cabin Republican, and men date women. And I've heard they even come from different planets Venus and Mars! At least a serodiscordant gay couple has the same kibble and bits! If James Carville can marry Mary Matlin and make it work, I'd say HIV magnetic couples should not be afraid to take a chance on love. I'm sure glad Steve did!

How did we make it work? Two guiding principles:

1. Communication is key.

2. Remembering to remember principle #1.

In addition, it's important to accept each other as different. The virally enhanced partner can't help but be concerned that he is cohabitating with a contagious germ that wants to put him six feet under. And HIV can make even a sex god feel his touch is toxic, even though his need for touch, pleasure, intimacy, and hot sex certainly does not decline with his CD4 count (nor should it!!!). Meanwhile Mr. Neggie may have survivor guilt for having escaped the cruel viral lottery. He may worry that his HIV+ partner will one day get sick really, really sick. Recognizing and accepting each other (and each other's concerns) as different is essential.

From discussing the issue with other magnetic couples, I can tell you HIV+'s feel better when HIV-'s share the worry of possible infection. Planning for the future can also be a tricky endeavor. There can be some discrepancy on how each views their long-term future and long-term goals. Pozitoids are often content to live in the moment, considering each moment "borrowed time." Neggies may want to save for retirement and that RSVP gay world cruise scheduled for 2025. But in reality these issues are now significantly different than they were for magnetic couples in the bad old days of the epidemic. Again, the very best advice we can offer anyone in our situation is to talk to each other really, really talk to each other. The tendency is just the opposite. Couples feel like they want to protect their partners from worrying or letting them know they are worried. Sure, you might say, "Life is complicated enough without having to teach someone what an HIV+ person has to live with," but then again, might the HIV- person have something equally important to teach us?

As for dating neggies that make you feel bad about yourself or who reject you because of your status, I'd suggest the following philosophy: if anyone blows a load of rejection or negative vibes your way, I say, "Spit, don't swallow!"

Finally, as for why they don't have me answering questions in the mixed status couple forum, I have no idea. But since I'm single-handedly manning two very busy forums already, I kind of hope "they" don't ask me. Maybe they'll ask Steve (Dr. Steve in The Body's Tratamientos Forum), my neggie prince charming and happily-ever-after. I'll post your question in that forum as well in the hopes it might help others struggling with challenges of what to do when opposites attract.

Good luck, Dave.

Dr. Bob

how safe is safe with poz boyfriend?? Oct 13, 2003

My boyfriend of 3 months is positive and I am negative as of last week. We are consistantly using condoms and I do not perform oral sex on him. Still, after sex I have paranoid feelings. Can I touch his precum/semen and infect myself somehow? How much risk is involved? What about broken rubbers? It never happened but could. All these nagging fears are taking a toll on my enjoyment of our sex life.

Response from Dr. Frascino

Hello,

You and your boyfriend need to have a serious discussion about sex and risk. We all take risks every day accelerating through that yellow light, walking in a rainstorm holding an umbrella (possible target for lightening), eating your mother-in-law's cooking, etc., etc., etc. We choose what level of risk we are willing to take. We all must do the same thing with sex. What were you comfortable doing with your boyfriend before you found out he was positive and you were negative? Ideally, we should all assume our sex partners are (or could be) HIV-positive, and take the appropriate precautions each and every time. By that logic, our behaviors really shouldn't change, even if one person is found to be positive and the other is not. Right? That's the ideal world. In the real world, now you know he's positive and you're not and suddenly "nagging fears" are hindering sex. Magnetic couples (one poz, one neg) need to decide together what level of risk they are willing to accept, agree to these rituals and limitations, and stick to them. This is called "negotiated risk" or "negotiated safety." You and your boyfriend need to review all the safe sex and risk info found on this site and related links, and then decide what level of risk both you and he are willing to accept, just as you would decide on the risk of going whitewater rafting or bungee jumping or on a date with O.J. Simpson. Others magnetic couples may decide they want to minimize even extremely small risks, so they may use condoms for oral sex. Communication is key. Once you both agree to the level of risk, and both agree to follow your rules each and every time, the "nagging fears" will go away. By the way, your boyfriend could be having "nagging fears" of possibly placing you at risk, just as you are having "nagging fears" about becoming HIV-positive.

What about broken rubbers? Since you know your partner is HIV-positive, if a condom fails and there is significant potential exposure, then PEP (post-exposure prophylaxis) would be warranted. Your doctor or your boyfriend's HIV specialist should be able to prescribe this for you. Start it as soon as possible, and no later than 72 hours, for it to have the best chance of working.

Finally, my lover and the center of my universe is HIV-negative (Dr. Steve Natterstad, The Body's expert in the Tratamientos Forum). I am positive. We're celebrating our 10th anniversary on World AIDS Day December 1, 2003. I'm sure we would qualify for an entire documentary on "The Joys of Magnetic Couple Coupling!" (Yes, it would get an NC-17). Hope this helps.

Dr. Bob



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