Transmission of chlamydia and HIV


Hi Dr. Bob,

I haven't been to The Body in awhile, but I have a couple of questions - and I would bet my grandmother there's nothing like this in the archives. I'll try to stick to the bare bones of the story. I'm a HIV+ gay man, who last year was living with a HIV- bisexual man - he knew my status. His main occupation is construction (picture a short muscular inked Jake Gyllenhaal - seriously. I know that's not bare bones, but it partially helps explain the way I acted). Matt (not his real name) supplemented his income with prostitution, not escorting, but street hustling. It was agreed that he would not do this while living with me. And yeah, I was living in a dreamworld. Fast forward 8 months (I'll skip the abuse and drugs aspect of what was going on)after he moved out. He started dating a girl, moved in, she left for the same abuse/drugs reasons (she knows all about me - ironically we get along quite well). Shortly afterwards she finds out she's pregnant (only 20 with her second child) by Matt. Her father, who is a social worked moved her out and did his best to keep her away from him. Eventually she caved and got back with him - and and about a month later he gave her chlamydia,which I just found out about today. Their baby is due in May. Matt and I stopped having sex after they got together, we maintained a sort of "friendship", and I know he was working the streets again to pay for his crack habit. The kicker is - we live in a cmall-ish city in Canada - and I know several of his "clients" and I know that several of them are HIV+. Matt told me last summer he had decided only to receive unprotected oral sex when "working" - but I know he's done more than that in the past - so who knows what the truth is. She has no idea what his sideline is (he told her he caught chlamydia from another woman, which is possible) and the chances of Matt telling her, or the doctor who is treating him, or his "clients" are slim to none. And the cherry on the cake - one of his johns is the director of youth community services for the province, and is the boss of the girl's father (could I make this up?) So I guess my main questions is - what are the chances of getting chlamydia from receiving oral sex? And assuming he's telling the truth, several poz men I know may have received chlamydia by performing oral sex on Matt - what kind of risk does this put them at? Part of me wants to "blow the lid" on the whole sordid mess, but I'm not sure if it's my biz at all. And if I did, I am putting myself at risk - Matt can be violent. I know many of these issues are not your area (other than the medical ones)- but no one in my life knows the whole story of what has been going on.



You would "bet your grandmother" there is nothing like your question in the archives? Oh brave, brave man. Do you have any idea how extensive and crazed the archives are? OK, so let's see, your story involves a short muscular inked bisexual Jake Gyllenhaal who is street hustling to support his crack habit and who abuses both you and a girlfriend and who also knocks the girlfriend up while giving her (and perhaps others) Chlamydia. OK, fine. Granny is safe for now but only because your violent bisexual Chlamydia-infected "Jake" is both muscular and inked! Otherwise you'd be kissing your Granny goodbye!

So, you are wondering if you should "blow the lid on the whole sordid mess." Well, that's one option. Another would be to sell the story to HBO for a miniseries. Although that bit about the director of youth community services for your province being both the boss of Jake's pregnant, Chlamydia-infected abused girlfriend's father and also one of Jake's sordid clients supporting his crack habit is a bit farfetched even for HBO. Here in the U.S. there is a program of anonymous partner notification through the public health department. That might be an option for notifying the health authorities without putting yourself at risk of Jake's violent tendencies. If that's not an option, notifying the local authorities and advising them of your concerns about potential violence if "Jake" knew you were the information source. They should be able to keep you out of the sordid mess as they investigate Jake's nefarious activities.

Good luck. Don't forget the possible HBO deal and give my best to Granny, OK?

Dr. Bob