Dear Rev. Pieters, My partner and I have been together in a wonderful loving relationship for five years. I've been positive for 13 years and he is still negative. We have a very open relationship and often have other sexual partners together. In our personal sex life (just me and him), we practice our own version of 'safer sex' that we are comfortable with, but when we are with others, we follow a stricter version of 'safer sex' recommended by my physician. I generally do not tell someone I am positive because there is no sharing of body fluids, but I will always disclose if the question is asked of me. For ourselves, we just automatically assume that anyone we are with is potentially hiv+ and limit our exposure to what we are comfortable with. I've always assumed others did the same. Recently an incident arose where a person we were with found out thru the 'grapevine' that i was positive and was extremely upset that I was 'spreading AIDS around'. Altho I think we presented him with an intelligent response, offered to answer any questions he had and directed him towards HIV resources, I am now grappling with this moral decision of whether to always disclose before any sexual contact and would appreciate your input. I won't go into detail, but some of the encounters we have are quite anonymous with hardly a word being spoken. Do I have a moral obligation to disclose in every situation? What if all I'm doing is performing oral sex on someone else with no reciprocation? Or mutual masturbation? It's getting to be a very complicated issue for me......can you help me?

You're right: this is certainly a "complicated issue!" In general, it is a very wise decision to "automatically assume that anyone we are with is potentially hiv+". And it's always a wise idea to practice safe sex, with both your partner and other people as well, based on this assumption. After all, you don't know for sure if your partner has always obeyed your "extracurricular" rules, and he can't know if you have.

If you're performing oral sex on someone without a condom, even when there is no reciprocation, you could be exposing yourself again to hiv, or to a different strain of hiv, or to other sexually transmitted diseases. And if your lover is performing oral sex without a condom or barrier on you or any of his sex partners, he is certainly running the risk of being exposed through "pre-cum" or at orgasm. There are many studies which show that oral sex without a condom can be a risky activity, even if he pulls out before orgasm. I know a number of HIV+ men who swear that unprotected oral sex was the only possible route of infection in their cases. I don't know of any cases of HIV being transmitted through mutual masturbation. So I am one who believes that there is risk involved in performing unprotected oral sex on your sexual partners. Of course, some people decide that this is a risk they're willing to take, pointing out that on the "safe sex continuum," it's not thought to be as risky an activity as unprotected anal sex.

In anonymous, non-verbal sexual encounters, it can be difficult to disclose your HIV status. Is it a moral imperative to disclose? In some areas, it's the law. Is it realistic to try and whisper the news in the midst of passion heating up? Probably not. When you question what's the morally correct choice in this case, there are those who might question the morality of anonymous, non-verbal sexual encounters, before you ever get to the decision about disclosure.

However, you've decided, as many gay (and some straight) couples have, that it is a morally correct choice for you to enjoy an "open" relationship. Ideally, you and your partner will continue to negotiate the openness of your relationship and the rules of safe sex. Whatever happens, keep communicating openly and honestly with him. It sounds like you've got a good start in all of this, but it's important to continue it.

You must decide for yourself the morality of not disclosing. Consider the consequences: the possibility of more people saying you're "spreading AIDS around" exists. People's fears about AIDS are not necessarily logical or rational. You could end up with someone being really angry with you, if you haven't given them the information and the choice. Are you willing to live with this?

Whether you disclose or not, safe sex (and that means using protection whenever semen, pre-ejaculatory fluid, vaginal fluid, or blood may be involved) is the wise choice. I know plenty of HIV positive men and women who enjoy great sex lives within the limits of safe sex. If you treasure your relationship the way you seem to in your letter, you'll want to do everything you can to protect your partner and yourself from any further exposure to HIV, while still relishing the joys of your sexuality!

Thanks for raising an issue that many HIV positive people wrestle with.