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Unusual Questions
Oct 28, 2009

Hi Dr.Frascino....I have an unusual question. I'm a negative female married to a pos man (undetectable since 1998.) I have a rare skin disease/autoimmune disorder called hidradenitis suppurativa. This condition causes me to have boil-like lesions in my groin/perineum and under my breasts. While my case is somewhat milder than others, I regularly have many sores at various stages in the healing process. Due to the inverse areas affected, the sores take a long time to heal. This condition is not contagious. In any event, with my husband being undetectable, we have decided that we would assume a small risk when making love. I give him unprotected oral (he seldom has any pre-cum) and we have unprotected intercourse, and he pulls out prior to climax. My questions are: 1) is this type of sexual contact relatively safe and 2) am I at any further risk if his semen comes in contact with my hidradenitis sores? I often wonder if like STD's increasing the chance for transmission, my condition would have a similar effect. Also, have you ever heard of my disease?

Response from Dr. Frascino

Hi,

1. Unprotected oral sex with a positive partner carries a low risk for HIV transmission, barring extenuating circumstances (oral cuts or lesions, concurrent STDs, etc.). Unprotected vaginal sex with pulling out prior to climax carries a much larger risk for viral transmission. I would recommend latex or polyurethane condoms for all penetrative sex, start to finish!

2. You would be at increased risk if HIV-infected semen comes into contact with non-intact skin (open sores or wounds).

3. Yes, I'm very familiar with hidradenitis suppurativa. I would encourage you to follow up with a dermatologist experienced in the management of this disease.

Dr. Bob



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