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Secondary prevention and fear of infecting others
Mar 22, 1999

Hi Rick, really get a lot from your site! Thanks for all the info. Have got a question and hope you may be able to resolve. I date a positive woman, have for nearly a year now. We practice safer sex - OUTERCOARSE - she isn't comfortable with intercoarse or oral sex. I really care for her, and although we dont have a conventional "sex life", I feel our "sex life" is very good I'm much closer to her than anyone I have dated! Now for the question, Last week I developed 2 small bumps on my finger - contact dermatis - from contact with a chemical, resin for auto body repair, a hobby - I had rubbed one of the bumps open - (it itched, I scratched) that night she and I had sex - kissing, body massages, mutual masterbation, afterwards she noticed the small sore on my hand and freaked out, I had really never noticed it, any way she is convinced she has infected me through the sore, I showed her your site - she visits the Body but only the Treatment forums. Showed her the section specifically related to fingering, she is still very worried, I told her without the sore its a NO risk activity, and with the sore its a very low risk activity, the sore proably contacted fluids, I touched her vagina only for 1 - 1 1/2, minutes was I right - I thought only neg. people were worried well, now our sex life is on hold, she has insisted we (I) begin wearing gloves, next will come goggles!, HELP.

Response from Mr. Sowadsky

Thank you for your question:

You are actually dealing with two separate issues here, so I will address them separately.

In response to the comment that she visits the Body, but only the Treatment forums:

We commonly see this happen in people who are HIV positive. For many people who are already HIV positive, their primary (and sometimes only) interest is in treatments. Many people who are HIV positive think that they no longer have to learn about prevention and transmission, since they already have it. What they often fail to realize is that learning about prevention and transmission (after testing positive) is even more important than ever. This is for several reasons:

1) A positive person needs to learn about ways to prevent exposing others to HIV. When we teach positive people about ways to prevent exposing others to the virus, the term for this is called "secondary prevention". In comparison, teaching prevention to people who are not infected, is known as "primary prevention".

2) In people who are HIV positive, learning how to practice safer sex is extremely important, in order for them to avoid being infected with other sexually transmitted diseases (STDs). STDs in persons with weakened immune systems may be more severe than normal, and may also be more difficult to treat. Also, some opportunistic diseases seen in persons with HIV are due to sexually transmitted infections (for example Kaposi's Sarcoma). In addition, in people who have HIV and another STD at the same time, HIV may be more infectious to others (see The HIV-STD Connection).

3) If a person already has HIV, reinfection with HIV may lead to further health problems (see HIV POSITIVE COUPLE CONTINUING SEX)

In response to your comment, "I thought only neg. people were worried well, now our sex life is on hold, she has insisted we (I) begin wearing gloves, next will come goggles!, HELP":

First of all, in regard to the gloves issue, there are times when using gloves may be a good idea, namely when you have open cuts, open sores, or dermatitis on your hands, and you are coming in direct contact with blood, vaginal secretions, semen, etc. Otherwise, using gloves is really not necessary. If she is fearful of infecting you even during low risk activities, this indicates a problem other than HIV itself.

Fear does not discriminate based on HIV status. Fear can affect anyone, whether a person is HIV positive or HIV negative. Anytime a persons fears begin to interfere with their day-to-day life on an ongoing basis, this indicates a mental health concern. In other words, if a person has ongoing fears that are affecting their relationships, jobs, friendships, and so forth, this suggests that there are mental health issues that need to be addressed. Counseling is the solution to these types of problems. In a case such as this, either one-on-one counseling, or an HIV support group, can help her overcome her fears. To find a local support group in your area, contact your local AIDS Hotline. To find the number of your local AIDS Hotline, go to the Hotlines and Service Organizations area here at The Body. There are also live support groups available through several online services, such as "America Online (AOL)." These online support groups are often found in the AIDS information or Health information areas. If you are a member of America Online, and want more information about HIV/AIDS support groups on AOL, contact me directly at my e-mail address listed below.

For more information about issues that arise when positive people date negative people (also known as "discordant couples"), I suggest you visit the Mixed-HIV-Status forum, found here on The Body.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).



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