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safe sex and the single girl
Sep 29, 2001

Dear Ryan,

I have recently been diagnosed hiv+ 3mths ago...I am currently on invarase, epivir and zerit and my cd4 count is 160 and my viral load was 932...Since being diagnosed i have experienced a great fear of being intimate with a man..I am afraid to kiss or get sexually intimate.is it ok for me to have safe sex...Is there a chance of me infecting a man if he performs oral sex on me or vice versa..

Response from Mr. Kull

Being recently diagnosed with HIV can be a very difficult experience for anyone, so keep in mind that the feelings that you are having are completely understandable. HIV infection not only changes the way you deal with your own physical health, but it has psychological and interpersonal ramifications as well. The greatest impact often occurs in how you communicate with others about being HIV infected and how you interact with partners sexually.

You are absolutely, unconditionally entitled to have sex (and enjoy it!). What you decide to do sexually will depend on the boundaries you develop for yourself. Having sexual intercourse with latex condoms is a great way to protect your partners from HIV infection. Condoms do break, but it occurs infrequently and usually does not result in transmission of HIV. Several studies that look at the rate of transmission among mixed HIV status couples who used condoms demonstrated that condoms were VERY effective in preventing transmission. See my response to "How risky is protected sex for a serodiscordant couple?" (http://www.thebody.com/Forums/AIDS/SafeSex/Archive/PreventionSexual/Q20149.qna).

Oral sex is always a tricky area in terms of transmission and prevention. HIV can be transmitted through oral sex, but transmission is much less likely when compared to unprotected intercourse. The available research also shows that women are much less likely than men to transmit HIV to partners performing oral sex on them. Only a few documented cases of transmission to a person performing oral sex on a woman have ever been recorded. See my response to "Women's risk of transmission..." (http://www.thebody.com/Forums/AIDS/SafeSex/Archive/TransmissionSexual/Q9740.qna).

Since transmission is possible through unprotected oral sex, asking your partner to use a dental dam or another barrier (a latex condom cut into rectangle or plastic wrap) during oral sex may help ease your worries. You also want to have your partners avoid having unprotected contact with you when there is the presence of menstrual blood.

There is research that shows being on HIV antiviral medication and having a low viral load reduces the chances that you will transmit HIV to your partners (again, see "Women's risk of transmission...).

Other activites, such as performing oral sex on your partners, deep kissing, and mutual masturbation, have not been shown to transmit HIV. Your saliva is highly unlikely to transmit HIV; there is no evidence that saliva is infectious.

The more difficult issues, like when, how, and if you tell your partners about your HIV status can be more complicated to sort out. If you are having safe sex with your partners, the need to tell them about your status is debatable. It can be really helpful for people struggling with the interpersonal difficulties that arise from being HIV infected to talk with other HIV infected people. Support groups are an excellent way to go. Check out your local AIDS service organization to see if any support groups are available to you. Regardless, you may also want to look into some individual counseling to help work through the complicated emotions that are arising for you.

Take your time and try talking about what's going on with you with people you can trust.

RMK



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