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educated but concerned
Jan 30, 2013

I have recently been dating a Hiv Poz male (I am female) and he has been on antiviral with undetected viral load for 5 years. We have protected sex and are cautious with other activities however I am still fearful of him transmitting HIV to me. Is condom usage enough to protect myself? If he has an undetectable viral load is oral sex safe without protection? I love him however I am concerned

Response from Mr. Cordova

Hi there:

Thanks for writing in. For the most part, yes. Condom use during penetrative sex is enough to protect yourself against HIV. I think oral sex without protection is still a safe enough activity. However, there is a risk. Deciding to not use condoms for oral sex is a personal choice.

Things to consider:

1. When possible, avoid brushing and flossing your teeth within two hours of oral sex. This will reduce the likelihood that you would have cuts or abrasions in your mouth that could facilitate transmission. When you are flossing, do it firmly. It will help toughen up your gums. This will help reduce the likelihood of your gums bleeding when you don't want them to.

2. PEP (post exposure prophylaxis) is a one month course of HAART that if started within 72 hours of a high-risk incident i.e. a broken condom with ejaculation during penetrative sex can help reduce the likelihood of transmission. Timing is key. Past 72 hours it is no longer effective; preferably it should be started within 24 hours, and immediately if possible. Having the medication on-hand can make this course of action easier to access. If you would like to consider this option I would suggest talking with either your doctor or your partners doctor. You will need a prescription for the medication.

3. Don't let your partner ejaculate inside of you. In the case of a condom breaking, not having your partner ejaculate inside of you will reduce the risk of transmission.

Bottom line: Keep up the condom use, consider PEP, and as for oral sex - the risk is low, but it is up to you to decide whether or not to use protection. Good luck.

In health,

Richard



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