Hi, I now have a HIV partner. He is always asking me just what is and what is not safe as far as sex is concerned. I am HIV-. As far as I know. We have pretty safe sex but sometimes we are a little risky. I don't want to contract HIV but I love him so it is so difficult not being able to perform some sex acts with him. So, my questions are... Can you contract HIV from his semen (no cuts) ? What are the chances ? Is it really that easy to contract or do you have to have a certain load of either blood, semen or otherwise at one time ? Also,if I am HIV+ (which I'm looking into now) can we have unprotected sex ? I mean would it matter anymore now that we are both infected at the same level. Being I contracted HIV through my partner who is very stable at this point ? We want to go on having sex if this is the case but I'm wondering, would it make any difference. I mean could we get worse if we have unprotected sex ? Or as long as we're taking our meds it would be just fine. I say this because I know where I got the HIV. I mentioned he is on meds and very stable. I'm hoping knowing this and keeping this in mind that we may continue having unprotected sex.
Response from Mr. Cordova
In a situation like this, there are varying levels of risk that you can take. The best way to protect yourself against HIV and most STD's is by using a condom for each and every act of penetrative sex. If condom use 100% of the time is not an option, then I would suggest condom use whenever you are on the bottom. This is because transmission is much for likely for the receptive partner (bottom). If your partner is on HAART, has had an undetectable viral load for at least six-months, and you both are in a monogamous relationship then there is evidence to suggest that transmission would be unlikely during unprotected sex.
HIV can be transmitted through semen (in addition to blood, breast milk, and vaginal secretions), but needs a portal of entry into the bloodstream of the uninfected person. During sexual encounters HIV is mainly transmitted during unprotected incidences of anal and vaginal sex.
You should consider talking to your doctor about Post Exposure Prophylaxis (PEP) as well. PEP is a 30-day course of HAART that when given within 72-hours (immediately is best) can help reduce the likelihood of infection. If you were to become positive, I would still encourage you to practice protected penetrative sex.
In regards to HIV testing, I would suggest testing every three months just to be safe.
It sounds like the two of you need to take some time to educate yourself on how HIV is transmitted. The section on HIV transmission has a wealth of information and I encourage the two of you to read through it together. You might also enjoy the section on Mixed-Status Couples. You'll find tons of questions and answers from people in your exact situation.
Bottom line: You guys need to communicate with each other about what risks you are willing to take with each other. Communicating about what you both comfortable with will help keep you both safe, and help strengthen the relationship. I hope this helps.
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