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Male Pos / Female Neg
Aug 5, 2008

I am an HIV + man now for 3 yrs , and have had undetectable viral load for the last year. I want to know how high the risk may be to my hiv negative girlfriend. We use condoms every time we have vaginal sex, and do not do anal. In our foreplay she sometimes will start to perform oral sex on me without a condom. I try to minimize this activity, but she doesn't know I am hiv +. I am not ready or able to tell her or lose her at this time, but I want to protect her until I figure a way to tell her. How much viral load is there in preseaminal fluid if you have been undetectable for a year. My meds seem to be working well with little side effects and hopefuly I will get the courage to tell before I give her HIV. Please advise, thanks jesse

Response from Dr. Frascino

Hello Jesse,

Here is what we know. Preseminal fluid (pre-ejaculate, pre-cum) can contain HIV and is considered to be an infectious body fluid.

That you use condoms for penetrative sex and your viral load has been driven down to undetectable levels would significantly decrease any HIV-transmission risk.

Unprotected oral sex carries only a very minimal risk for HIV transmission.

I'm most concerned about your comment, ". . . hopefully I will get the courage to tell before I give her HIV."!!!! Jesse, I strongly urge you to disclose your HIV-positive status without delay. Not only is it the best way to cope with your guilt; it's also the right thing to do. What if the situation was reversed? Wouldn't you want to know? The longer you wait, the more difficult disclosure may become and the more likely you will be to lose your girlfriend. She will feel you've been deceiving her and possibly putting her at risk. Jesse, you clearly know what needs to be done. I urge you to do it without further delay.

I would also recommend you peruse the information in the archives. We have whole chapters devoted to magnetic couples (one positive, one negative), safer sex techniques, sexual HIV prevention, etc.

Good luck.

Dr. Bob



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