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Is this significant?
Oct 8, 2008

Dear Doctor,

Thank you so much for your contribution to this site. Back in March I tested positive and just when I thought there was nothing to smile about given my diagnosis I unearthed your own unique brand of humour. You've managed to take some of the sting out of my reality. Anyways my question is this - my husband (and only partner for the last nine years)just had his test results returned as negative after having a first test the day after I tested positive, 6 weeks after, 3 months and then 6 months after. Since my diagnosis we've always had protected sex-(even though for the 10 preceding years of our relationship we had not). If we were to continue doing so (and we will), is there any significant risk that he may turn out positive even after this last check? At what intervals would you recommend he be tested? Thank you.

Response from Dr. Frascino

Hi,

If indeed your husband has been your only sexual partner for the last nine years and he has consistently tested HIV negative, you would have had to acquire your infection before getting together with him or via some other route (sharing intravenous drug paraphernalia, etc.). If you've had essentially no HIV-risk exposure over the past decade, I would suggest you recheck your HIV test to confirm your status and rule out the possibility of a false-positive test.

If indeed you are "virally enhanced" and your husband has tested HIV negative out to six months from your last unprotected encounter, he is conclusively HIV negative. If you continue to practice safer sex and properly use a latex or polyurethane condom and if the condom does not fail (break), his risk of acquiring HIV would be essentially nonexistent. HIV cannot permeate intact latex or polyurethane. No way. No how. I would advise you and your hubby to read through the chapter on magnetic couples in the archives of this forum. I'll also repost some information below that discusses some extra precautions magnetic couples may want to consider to further decrease HIV-transmission risk.

As for routine HIV testing, your husband might consider testing at the time of his yearly physicals.

Dr. Bob

Hiv infection? Magnet couple stress and fear (MAGNETIC COUPLE SEXUAL RISK 2008) Oct 8, 2008

I am negative at the moment and my boyfreind is HIV positive. he is an HIV educator actually.

After I accepted his status, we finally became intimate with each other. I did oral sex on him 3 times that night. Twice on his penis and once with his ass. He precums almost instantly (I don't know if its just with me lol), but I feel like despite the wealth of knowledge about the risk of unprotected oral sex I feel like I may have exposed myself. I didnt not swallow much if any precum. I had a little after taste and I mouthwashed mid session. I only have minor gum bleed after toothbrushing. I am a little concerned about anal oral intercourse too even thought I saw no possible way i could get infected. He penetrated me with a condom and i am not concerned about infection there.

I just want to feel a little assured about my chances for infection here. I love him so much and I find it hard to be intimate with him without thinking about his status. It's a reason why I can't put myself in a condition to penetrate him. And I feel horrible even thinking about talking to him about it because he is an HIV educator and probably know more than most about safe sex practices. Gawd, Just thinking about it and letting my mind run amok about possible infection makes me want to cry becasue I dont want to hurt nor loose him, but I want to trust him with us and our intimacy. And I want to be able to give him my all when we make love without holding myself back.

Given what I said, what were my exposure risks. And what advise do you have for me and the relationship with the one i can see myself with forever?

Response from Dr. Frascino

Hello,

Your HIV-acquisition risk is extremely low. There have been no documented cases of HIV transmission due to rimming or getting rimmed. Oral sex carries only a very slight risk for HIV acquisition/transmission. You can read much more about this in the archives of this forum. We have entire chapters devoted to oral sex and sexual-HIV transmission risk.

Regarding your concerns about sexual activity within a magnetic relationship, as you might imagine, you are not alone. It's something all magnetic couples must come to terms with. Communication is key and that is what is lacking in your current relationship! That your Mr. Right is an HIV educator should make communication easier, not more difficult! Chances are he's as worried about infecting you as you are about acquiring the virus. The two of you are overdue for a heart-to-heart (note that's heart-to-heart, not hard-to-hard) talk! You need to openly discuss your concerns and together the two of you need to develop sexual rituals based on what is known scientifically about the HIV-transmission risk and on your individual levels of comfort. I suggest both you and your Mr. Wonderful read through the chapter in the archives devoted to magnetic couples. You'll soon see your concerns are shared by many of us in serodiscordant relationships. In addition to taking equal responsibility to make sure HIV is not transmitted, there are a number of other measures the two of you might want to consider to further reduce transmission risk:

1. Have your poz-partner take antiretrovirals to drive his HIV plasma viral load down to undetectable levels. This will significantly decrease transmission risk.

2. Get a starter dose of PEP (post-exposure prophylaxis) to have on hand just in case there is an accidental exposure (condom break).

3. Consider PrEP (pre-exposure prophylaxis). This involves the negative partner taking antiretroviral medication prophylactically on a routine basis. We still don't know if this approach is effective. Clinical trials are underway. Some magnetic couples aren't waiting for the results of the trials, but rather are instituting PrEP as a harm-reduction strategy now.

You can read much more about PEP, PrEP and other risk-reduction strategies in the archives.

Finally, I want to assure you from personal experience that opposites attract and that happily-ever-after can indeed become a reality for magnetic couples. Steve (Dr. Steve, the expert in The Body's Tratamientos forum) is HIV negative. I'm "virally enhanced." We've been happily-ever-aftering for 15 years and yes, that includes toe-curling, wake-the-neighbor, own-name-forgetting fusion sex. My advice to you is to make sure Mr. Right doesn't get away for all the wrong reasons.

Good luck to you both!

Dr. Bob



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