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HIV+ and ready to date for the first time
Jan 9, 2010

Dr. Frascino- First I am very gratefull to have had a site and experts like yourself to rely on during those dark and lonely nights after being diagnosed three years ago (CD4 less than 150). Three years later CD4 in 400's, virus undetecable and my Dr.'s comment on % = "excellent".

I recently spent time with an acquaintance. And we both admitted longetime crushes. I got carried away in the moment with feelings I hadn't felt in many years, but did not yet disclose my HIV status. We've kissed (tongue in mouth) and I did let him perform oral sex on me briefly. He really wants to get to know me better and it hit me like a brick what the consequences of my actions and non-disclosure could have.

I know that I should have, and now definitely need to disclose my status before we go out again. Needless to say, I feel like an absolute piece of dirt and am preparing for the worst reaction from him (one rightly deserved). He is a great guy and I realize he needs to know my status. I know he will need to get tested, and I tried to read up on the level of risk that I put him in.... but am confused. 1) Both of us have good teeth/gums, what really was the level of risk in the make-out session of transmitting HIV? 2) Oral sex he performed on me was brief, but nevertheless a risk, not having ejaculated in his mouth, what was the level of risk? I have learned a valuable lesson for the future and hope that he doesn't pay for what I failed to disclose.

Response from Dr. Frascino

Hi,

Certainly I strongly advocate disclosure; however, remember, it takes two to do the unsafe sexual tango! Yes, nondisclosure could have disastrous consequences. However, everyone who voluntarily has sex needs to take personal responsibility and to follow Dr. Bob's two cardinal rules:

Dr. Bob's cardinal rule #1: We must always consider that all of our sexual partners could be HIV infected and therefore take all the necessary precautions to prevent the transmission of the virus.

Dr. Bob's cardinal rule #2: Always remember Dr. Bob's cardinal rule #1.

I agree with your decision to disclose your status, and the sooner the better. However, if your buddy goes ballistic, he must shoulder at least 50% of the blame.

As for his HIV-acquisition risk, it's very low. Make-out sessions are not considered a risk for HIV transmission. Brief unprotected receptive oral sex without ejaculation is considered a very low HIV-transmission risk. That your HIV plasma viral load is undetectable significantly decreases this already very low risk.

I'm confident your new potential Mr. Right did not contract HIV form this brief sex-capped. Hopefully your delayed disclosure won't screw up this budding romance.

Good luck.

Dr. Bob



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