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Worried + man in discordant relationship
Aug 15, 2008

Hello, I have been positive for only 3 yrs plus and have had a negative girlfriend for all 3. We practice safer sex and she has numerous negative tests. I confide in her that we should go to counsleing becase I feel guilty after each sexual encounter. Let me pose this question when we are in the heat of the moment sometimes we grind and my penis comes close to her vagina and sometimes even enters without protection stupid we know how far is too far in fore-play before I put on a condom. Thanks and I already donated twice in the past.

Response from Dr. Frascino

Hi,

Frottage (grinding without entering) is not considered a significant HIV risk. However, once Mr. Happy enters the love canal without being properly dressed for the voyage, risk ensues! I'd recommend putting the condom on early in your foreplay activities. That way you won't have to worry about those heat-of-the-moment slip-ups (or should that be "slip-ins"?).

I'd also recommend you and your partner read through the chapter on magnetic couples in the archives of this forum. You shouldn't feel guilty after each sexual encounter! If you both agree in advance what "safe enough" is based on what is known scientifically about the HIV risk associated with various sexual activities and what you are both comfortable with, guilt should not be an issue. Couples counseling can help, particularly if communication on this issue is difficult. Magnetic couples are most successful when both individuals take equal responsibility in assuring that HIV is not transmitted to the negative partner. There are other levels of safety and harm reduction you could consider, including:

1. Making sure your plasma HIV viral load is suppressed to undetectable levels. This will significantly decrease the risk of HIV transmission if there is an accidental exposure.

2. Consider asking your HIV specialist for a PEP-starter pack and instructions on how and when to use it in case of an accidental exposure.

3. Consider enrolling in one of the clinical trials of PrEP (pre-exposure prophylaxis). We don't know yet what level of protection, if any, this will provide for the negative partner, but we are hopeful it may well turn out to be a major harm-reduction strategy for the future.

Thank you for your donations to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). They are warmly appreciated.

Finally, from one magnetic couple to another, be well, stay well.

Dr. Bob



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