I m a poz female and have been on meds for 2.5yrs. My VL is undetectable. I recently met a guy and we started to get intimate. I would ask him to put on a condom, initially he agreed but then he would take it off as he could not reach orgasm with condom on. What are the chances that he would get infected if he does not use a condom?

Hi,

Being on effective antiretroviral therapy that decreases the HIV plasma viral load to undetectable levels significantly decreases, but does not eliminate, the risk of HIV transmission. Every time your boyfriend decides to forego the latex condom, he is playing sexual Russian Roulette. He may dislike condoms, but both you and I know that he would hate having HIV/AIDS so much more! I should also point out that not using a condom also places you at risk for unwanted pregnancy and other STDs. It takes two to do the unsafe horizontal mattress mambo. I'd suggest you advise your feckless boyfriend that it's "no glove, no love!" And stick to your rule! If he takes the condom off, the fun should immediately stop and not resume until he replaces it. Suggest he try the newer ultra thin condoms, like Maxx or Kimono, and to put a drop of water-soluble slippery stuff in the tip of the condom to increase the sensitivity.

I plan to write a blog about common condom complaints and conundrums for this Web site. It should be posted by the end of the month. Have your boyfriend check it out.

Dr. Bob