Question

Dr F

My partner is HIV+ and I am referencing this for others out there who may be in similar situations. Pre-cum is not Scientifically PROVEN to transmit the virus, or as I prefer to say contain enough virus' to transmit the virus. Your statement may be interpreted incorrectly in this circumstance for sero-discordant couples. Pre-cum does contain enough virus to transmit HIV during anal sex, although much lower than with ejaculation, the risk is present. Please reinstate this answer for persons who are involved in sero-discordant relationships, or even those who are researching what IS/IS NOT risk. Thank you

Answer

Hello,

I, too, am in a sero-discordant relationship. (A more positive way of saying that is "magnetic couple," as in one positive and one negative. You know how magnets attract each other!)

Thank you for your opinion. I agree that pre-cum has not "scientifically" been "proven" to transmit virus, and I never implied that it was. I also agree that pre-cum has been "scientifically proven" to contain virus. Consequently, there is a potential risk for HIV transmission. There really is no ethical way to prove or disprove this potential risk, as the definitive study could never be performed. No question that anal receptive sex with ejaculation is the riskiest behavior of all. Other sexual practices carry varying degrees of risk. What you can NOT do is emphatically state there is absolutely no risk to pre-cum orally. What you and your partner have decided between the two of you is called "negotiated risk." You both know that pre-cum contains virus, that there is no scientific proof that HIV can be transmitted by pre-cum orally, and - I hope - that despite this, there is still a potential risk of transmission. I agree that the risk potential may well be very low, but it's not zero. So the two of you have to decide how much risk you are willing to take. Life is full of those kinds of decisions. Do I drive 65 mpg in a 50 mph zone? Will I walk outside in a lightening storm? Will I eat my mother-in-law's pot roast? Life is never without risk. My job here is merely to explain the facts so informed decisions can be made by you and your partner (and by me and mine). Just for the record, I occasionally drive 65 in a 55 mph zone, often walk outside in lightening storms, but never, ever, ever, will I eat my mother-in-law's pot roast.

Stay well. Thanks for waiting!

Dr. Bob