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what activities are considered safer sex
Nov 20, 1996

I am HIV positive, although show no viral load with no medication. What activities are consider safe or very low risk to a female partner. Also, I currently have my first girlfriend since diagnosis, and will have to inform her of my condition. What if any suggestions might you give on how to go about this. What or who makes alternative condoms, aside from latex. thank you in advance I greatly appreciate the information I have received from you.

Response from Mr. Sowadsky

Hi.Thank you for your question.

Rather than listing everything that is low risk, it's easier to say what is high risk, so you can avoid exposing her to the virus. The way to determining what is risky for HIV and what isn't, is to keep in mind how HIV is transmitted.

Blood, pre-cum, semen, vaginal secretions, and breast milk all contain high concentrations of HIV, and all have been linked to transmission of the virus.

Saliva, tears, sweat, and urine can have the virus in them, but in such small concentrations that nobody has ever been infected through them. However, if any body fluid is visibly contaminated with blood, the risk of transmission exists.

The HIV virus must get into the bloodstream in order to infect you. If it doesn't get into the bloodstream, you will not get the infection. Blood, pre-cum, semen, vaginal secretions, or breast milk must have direct access to your bloodstream in order to infect you. Activities where this can happen include vaginal intercourse (both partners), anal intercourse (both partners), giving oral sex, sharing needles (IV, tattoo etc.), and rarely through receiving a blood transfusion. HIV can also be transmitted from mother to child. HIV is NOT transmitted through any form of casual contact.

In summary, in order for infection to occur, 3 things must happen:

You must be exposed to pre-cum, semen, vaginal secretions, blood, or breast milk. The virus must get directly into your bloodstream through some fresh cut, open sore, abrasion etc. Transmission must go directly from 1 person to the other very quickly.....the virus does not survive more than a few minutes outside the body.

No matter what the circumstances are, if you think about these 3 criteria for transmission, you'll be able to determine whether you're at risk for HIV or not. But do remember that other sexually transmitted diseases (STD) can be transmitted easier than HIV, so what might be low risk for HIV may be high risk for other STD's.

So sexual activities that involve direct exposure to your pre-cum, semen, and blood are considered risky. This includes someone giving you oral sex, and also unprotected vaginal and anal intercourse. These are the most common high risk sexual activities.

There is no one way to break the news of your positive status to your partner. But remember the following guidelines that may help you out.

Tell your partner that you are infected BEFORE engaging in any sexual activities. In some places, you have a legal obligation to tell your sexual partners ahead of time of your positive status.

Tell your partner when you feel comfortable in your level of communication with them. This takes time. There is no rush in telling a person that you're positive, just as there is no rush in having sex with a person. Tell her you're positive when you feel you are comfortable with discussing the issue with her, and you feel she may be more comfortable with hearing what you will tell her. This is never an easy thing to do, but get to know her ahead of time before breaking the news to her.

Don't tell her immediately before you are going to have sex. Try to break the news to her as far ahead of time as possible. The earlier that she knows, the easier that she may be able to deal with the issue.

Tell her in a private setting. Avoid breaking the news to her when she is "having a bad day". Break the news to her at a time when she is ready to listen to it.

Of course, these are only broad suggestions. There is no easy way to break this type of news to someone. It's never going to be easy, and every situation is different. The best thing I can say is not to rush into telling her, until you feel more at ease in telling her, and you think she is ready to hear it.

In regard to non-latex condoms, there are 2 types of non-latex condoms that can protect against HIV and other STD's that are available. Both are made out of polyurethane, a type of plastic. Polyurethane condoms can be used with any type of lubricant (unlike latex condoms which MUST be used with a wat erbased lubricant). They can also be used for persons who are allergic to latex.

There is the male polyurethane condom, sold under the brand name, "Avanti". There is also a female condom, sold under the brand name, "Reality". Both of these condoms can protect you and your partners against infections, although the male latex condom offers a higher level of protection, based on currently available studies.

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



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