Aa
A
A
A
Close
STDs Forum
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Avatar universal

HIV /HIV-

Dear Doctor Handsfield--

I realized you don't get too many posting from females, but I hope that you do not mind.   I am a 25 year-old female, and was diagnosed with HIV about 1 year ago.  

I haven't had sex of anything since then, but now I finally met a man (he know of my HIV-status).   I had some safe sex questions, which I hope you could respond to.  I have consulted with my HIV doctor, but her response was that "it's all Russian Roulette."   Not very helpful.

My boyfriend and I have drawn up a plan of action to avoid him getting HIV.  Thus, far we have decided:

1.  ABSOLUTELY NO anal sex, even with a condom, because a condom can tear easily in the anus.   No exceptions here.

2.  No peforming cunnilingus on me, because I do not want to expose his mouth to vaginal secretions.  No exception here.

3.  BUT:  I will  perform fellatio on him.   Can we be sure that he will not get HIV this way?   Everything I've read points to this being NO RISK to HIM, ABSENT extenuating circumstances.  Is this true?  I'd really appreciate your input on this.  What would be the extenuating circumstances that I need to be on the lookout for?   I'm not liking the idea of using a condom for performing oral on him.

4.  Lastly, I wanted to ask about vaginal sex.  

    Assuming we use LATEX condom (no lambkin, of course!) with ample WATER-based lubricants, AND assuming the condom does NOT fail, can we be sure that I will not transmit HIV to him?  Again, this assumes that NO condom failure occurs.    

We are willing to take the risk that "condom failure may occur."  

But is there enough scientific evidence (i.e., "comfort") to state that a LATEX condom that does not fail will stop HIV trasmission (for vaginal sex, of course).  Otherwise, I can totally see where my doctor's "russian roulette" comment derives from.  

5.  My next goal is to find a more suitable HIV doctor to talk about this.  I suspect that saying "it's Russian roulette" is NOT a standard response from most HIV/STD specialist.

As you can see, I'm nervous and scared.  I'm REALLY SORRY if my questions come off as TOO scared, doctor.
11 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the STD Forum.  Many women have posted questions; you are right about the male predominance, but that is entirely unrelated to my or MedHelp's preference.

Congratulations on the rational approach you are taking to sexual safety and your new partner.  With care and caution, he can avoid being infected.  I will respond to each of your comments/questions, then add a couple of additional precautions at the end.

1) Good choice about anal sex.

2) Cunnilingus really isn't all that risky; few if any people have ever been infected by that practice and you really need not avoid it.  Or if you wish to take that step, you could use a barrier such as saran wrap. (Lots of people recommend latex dental dams, but plastic wrap undoubtedly provides equal protection and many people prefer it.)

3) There are a few reported cases of HIV acquistion from an infected oral partner by fellatio, but it has never been proved and is very low risk.  As for cunnlingus, you can reduce the risk to truly zero by using condoms.

4)  You are correct that latex condoms, properly used, are virtually 100% protective.  "Properly used" means no genital contact (and of course no penetration) until the condom is in place; and withdrawal while still erect, while holding the condom in place on the penis.

5) It is unfortunate that some HIV providers are not truly up to speed on preventing transmission.  But they are out there.  In most cities in the US (and, I presume, in other industrialized countries) there are community organizations devoted to advice, counseling, and assistance to infected women.  Look for one, and get word of mouth advice about providers from other infected people.

The other thing you can and must do is keep track of your own health.  You need to know your CD4 count and viral load, which should be checked at least twice a year and perhaps more often, depending on their current values and other factors.  When your viral load is low, your risk to your partner is very low, even in the event of condom breakage.  If/when you are on antiretroviral therapy (ART), follow the regimen religiously; complying with therapy keeps the viral load low and will markedly reduce the potential for transmission. (There are varying medical opinions about when to start ART, based largely on viral load and CD4 count. But the desire to prevent transmisison is on factor that can and should influence the decision.)  Finally, if you get sick, stop having sex until you know what is going on.  Some illnesses can transiently raise viral load; it is common sense to assume you may be more infectious if you get influenza, for example.

You may be nervouse and scared, but you strike me as someone with a level head.  HIV or not, I think your boyfriend has a good deal going.  Best wishes to you--

HHH, MD
Avatar universal
Although the risk to my boyfriend from ME giving him oral sex is not proven, (aside from a condom), do I avoid transmitting HIV to him (when I perform fellatio on him), by finding a way to decrease the saliva levels in my mouth.    

I suppose the lesser saliva, the lesser infection chance, correct?


Perhaps this can be accomplished by using a lubricant on his penis instead of saliva to perform fellatio??
Avatar universal
Curiousgirl,

I'm so happy that you have found a partner who is supportive of your HIV status and that you are living life to the fullest with this disease. Your boyfriend must be a very understanding person and he must be an incredible guy. For our forum would it be rude of me to ask the following:

(1) Hod did you contract the virus
(2) Did you have any ARS symptoms and how long after infection did these symptoms arise.
(3) Also how long after you were infected did you test positive on your test.

I'm sorry if these are rude questions as I don't mean to be. It's just that a lot of the questions on these boards relate to the above and really there hasn't been any real cases here. I admire your courage.



Avatar universal
None of your damn business, vs7829.

Please don't ask such intrusive question.
Avatar universal
I apologise - I didn't mean to offend - sorry!
97676 tn?1340408973
God bless you curiousfemale!
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Here are 16 facts you need to know to protect yourself from contracting or spreading a sexually transmitted disease.
How do you keep things safer between the sheets? We explore your options.
Can HIV be transmitted through this sexual activity? Dr. Jose Gonzalez-Garcia answers this commonly-asked question.
A breakthrough study discovers how to reduce risk of HIV transmission by 95 percent.
Dr. Jose Gonzalez-Garcia provides insight to the most commonly asked question about the transfer of HIV between partners.
The warning signs of HIV may not be what you think. Our HIV and STD expert Sean Cummings reports in-depth on the HIV "Triad" and other early symptoms of this disease.