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Frequency of testing?
Apr 27, 2009

Hello Dr. Bob,

I am in a monogamous relationship with my boyfriend. He is HIV positive and I am HIV negative. We always use condoms when having anal sex. However we do not use condoms when having oral sex. Also there is no ejaculation when we have oral sex. My question is how often should I get tested?

Thanks-

Joe

Response from Dr. Frascino

Hi Joe,

There are no specific guidelines for how often someone should be tested in your particular situation. Some suggest testing every six months for those who are sexually active with multiple partners.

Your HIV risk is limited to oral sex with your Mr. Right-positive guy. Oral sex carries only a very low (but not completely nonexistent) risk for HIV transmission/acquisition. Receptive oral is riskier than insertive. If your stud-muffin is on antiretrovirals and has driven his viral load to undetectable levels, the risk of viral transmission would be significantly reduced for all types of exposures.

I'd suggest you get tested whenever there is a significant exposure, such as a broken condom, or every six months.

As a magnetic couple, you might also consider some harm-reduction strategies, such as having a starter dose of PEP available in case there is an accidental significant exposure. You might also consider PrEP (Pre-exposure prophylaxis). Several clinical trials are enrolling to evaluate the efficacy of this intervention. Some HIV specialists aren't waiting for the results of these clinical trials and have already begun prescribing it for some of their magnetic couples. Please note that PrEP would be used in addition to, not in place of, condoms.

Good luck to both you and your Mr. Happily Ever After.

Dr. Bob



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