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Welcome to the forum. Thanks for your question. Let me start by congratulating you on your decision to move into a sexual relationship with your HIV infected partner and for the wise and sober approach you are taking to sexual safety. You're off to a great start! However it is possible you are overdoing the sexual safety part. I'm happy to confirm the advice and information you received 4 weeks ago from Dr. Cummings on the international forum so we need not further discuss kissing mutual masturbation fingering etc -- all of which carry no risk even for contact with partners with untreated HIV with high viral loads. The same is true for oral sex. Even without ARV therapy one estimate is that if a male (penile) partner has HIV the risk to his oral partner averages once for every 10000 exposures. That's equivalent to performing fellatio on infected men once daily for 27 years before transmission might be likely. With your partner on ARV therapy -- especially if he has a low or undetectable viral load in the blood -- you can safely consider oral sex to be zero risk even with ejaculation in the mouth. In fact if his viral load is low or undetectable I would advise you to also go ahead with condom-protected vaginal or anal sex or any other sexual expression that gives you mutual pleasure. Even without a condom vaginal and anal sex probably would be safe but the conservative approach and standard advice is that condoms should be used as well. OTOH some couples in your situation don't use concoms especially during times they are hoping to conceive a child -- something for you to know if parenthood is in your plans. The only slight uncertainty here is that his viral load "dropped accordingly". As noted the advice above assumes excellent control ideally with undetectable viral load. This is something to discuss in detail with your partner and he with his doctor. Which leads to my final advice: that you accompany your partner to his next doctor/clinic appointment so you can both have a conversation with his doctor -- or perhaps with a case manager or prevention counselor in the clinic -- about your sexual plans. I'm sure they will confirm my advice above but you probably will find it reassuring to hear it in person. (If he is in care at a smaller facility without prevention expertise then you probably could make a joint appointment at your local or state health department instead -- or its equivalent if you're in a country other than the US.)

2015-04-08 11:40:06

Sun