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Repeat of previous unanswered question re: relative risk of certain sex practices in magnetic relationship
Feb 21, 2010

I sent this question in a few days ago and haven't seen a response as of yet. I know that "relative" risk is not an easy thing to determine. However, it would be very helpful for me (HIV+) with undetectable VL and no other STD's to explain to my HIV- partner exactly how safe/unsafe (relative to unprotected oral) it is for me to insert my unprotected penis into his anus. I have no precum to speak of and I only put my penis in for 5 minutes, just long enough for him to get off. Can you help us to determine the relative risk of this behavior? I will say that this is behavior that has been in the past but will not be done from now on.

Response from Dr. Frascino

Hi,

The CDC estimated per-act risk for unprotected oral sex versus unprotected receptive anal sex with a partner confirmed to be HIV infected is 0.5 per 10,000 exposures versus 50 per 10,000 exposure respectively. Therefore, the relative risk would be a hundred times greater. Unfortunately, we don't have a way to factor in many individual variables that could affect a specific coupling, such as viral load, concurrent STDs, trauma, immune integrity, viral strain, genetic factors, etc. The bottom line is that anal sex is much, much riskier than oral sex!

Dr. Bob



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