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How safe is it to have sex with my HIV-positive boyfriend?

June 27, 2007

Question (The following Question/Answer is provided by HIV InSite.)

I am HIV negative, I have been tested twice, I am thinking about dating a guy with AIDS who was diagnosed seven years ago and has been doing well physically for 3 years. His T-cell count is 202. How safe is it to open mouth kiss, french kiss, to deeply kiss him? Also how safe is it to have vaginal sexual intercourse? I heard if you use 2 condoms that it is safe. I really like this person a lot but I am scared to death to kiss him or have intercourse with him.

Answer

I'm glad you are thinking about these questions now, rather than when you are in his arms and letting your desires determine what risks you take. The key is to take things slowly, communicate with each other at each stage, and be honest with yourselves and each other about your fears and the potential consequences of any risks you take.

The risks of HIV infection depend on more than what you do with each other sexually. For example, more important than his CD4 count is his viral load. A high viral load and any STDs on either of you really increases the risk of transmission because both will increase the population of virus and infectable cells. For this reason, an STD checkup may be in order for both of you. Even if he has a low viral load, this only reflects levels of HIV in his blood. Levels in the genital tract where semen is produced can be much higher, particularly if there is an infection such as an STD, which has been shown to increase production of the virus.

You asked about kissing and intercourse specifically, but there are a lot of safe things along a continuum between these two. Pretty much anything you can do with your hands, or "outercourse," is a lot safer than penetration by his penis. Another "outercourse" method, for example, is rubbing his penis between your butt cheeks while you lie flat on your stomach. Using some water-based lube really helps. If having his penis inside you is important, then you need to find some good quality condoms that fit him well. He might have a brand that he likes, otherwise go with a Japanese made condom. I'm not sure whether double bagging is safer than just one condom. Two condoms rubbing together might increase friction and cause them to break. Two condoms may also be more likely to slip off due their greater combined bulk than a single, sheer condom.

Oral sex on you is safe, however if you go down on him there is a risk of transmission. To reduce the risk you can either use a condom or be sure to squeeze out and wipe off any precum and avoid getting cum in your mouth. The risk of oral sex, including deep kissing, really depends on the health of your gums and throat. If you have bleeding gums or a sore throat, then I would avoid kissing and oral sex until these have been resolved. One way to reduce the risk of bleeding gums is to use mouthwash instead of brushing and flossing when you are together because brushing and flossing can cause little scrapes and cuts in the gums.

Source:
How safe is it to have sex with my HIV-positive boyfriend?
Answered by Nicolas Sheon, HIV InSite Prevention Editor
http://hivinsite.ucsf.edu/insite?page=ask-01-01-01

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Posted at 10:35 AM by Shantrie in the HIV & AIDS category/ies.