HIV positive BOYFRIEND (MAGNET COUPLES AND SAFER SEX)
Sep 8, 2008
Dear doctor, We are male gay couple.My b/f is HIV+ and I am HIV- /as for 2006/. We do protected anal both ways and unprotected fellatio /yes, I did swallow it once/. Should I get tested for HIV?
What are your general sex recommendations for serodiscordant gay couples?
Thank you for your response,
Response from Dr. Frascino
What are my general sex recommendations for serodiscordant gay couples??? Hmmm . . . Why?? Are you guys running out of ideas? Have you tried the reverse cowboy position while on a trapeze? It's challenging, but way fun. Oh, perhaps that's not what you meant.
You are a magnetic couple (one poz, one neggie). First off I would suggest you read the chapter on magnetic couples in the archives. In addition, you should peruse the HIV Sexual Transmission and Safer Sexual Practices chapters as well. That will give you a firm basis for making informed decisions about your relationship. You and your poz-stud-puppy need to create your own sexual rituals that are based on what is known scientifically about the risks of HIV transmission plus on your individual comfort levels for various sexual activities. As for what's known scientifically about the HIV risk associated with various sexual activities, check out http://hivinsite.ucsf.edu/InSite?page=kb-00&doc=kb-07-02-02.
Regarding unprotected oral sex, well, not surprisingly, we have a chapter devoted to that subject in the archives as well! Check it out! The risk of HIV transmission/acquisition from unprotected oral sex is very low, but not completely nonexistent. Many magnetic couples have decided this level of low risk is "safe enough" for them to forego the latex wrap on their penis Popsicles. Others may not be comfortable even with a low or very low risk. Communication is key. You and your partner will need to decide what's right for you. As for HIV testing, most guidelines suggest HIV screening every six months for sexually active gay men. This seems reasonable to me.
Marek, I, too, am part of a magnetic couple. My mate, Steve (Dr. Steve, the expert in The Body's Tratamientos forum) is HIV negative and I am "virally enhanced." We've been together for 15 years and the sex continues to get better and better. (Yep, toe-curling, own-name forgetting, wake-the-neighbors type of sex!) You might also consider talking with your partner's HIV specialist. There are a number of ways to reduce the risk of HIV transmission for serodiscordant couples, including:
1. driving the HIV plasma viral load to undetectable levels with antiretroviral therapy;
2. availability of a starter dose of post-exposure prophylaxis (PEP) in case of accidental exposure (broken condom, etc.); and
3. consideration of PrEP (pre-exposure prophylaxis), whereby the HIV-negative partner takes antiretroviral drugs to prevent infection. (We don't know if this approach is effective or not, but clinical trials are underway and the preliminary results look good so far.)
OK Marek, those are my general sex recommendations. Oh, plus, don't forget that reverse cowboy position!
Be well. Stay well.
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