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HIV and AIDS

Possibe Risks of HIV Transmission From a Positive Woman To A Negative Male

11/22/2005

Question:

Thank you so much --your the greatest- and I really, really need your help. Questions: I`m a postitive female, my man is negative. I love him very much and want to save this relationship. Here are some of my questions:

1)going down on me after I urinate, how risky is that? I`ve heard drinking urine is fine so is licking up okay?

2) masturbation by my partner. Is it safe for him to play with me with his hand even though there are vaginal fluids involved?

3)- we practice safe sex, but does he need to worry about coming in contact with my vaginal fluid to remove the condom or any vaginal fluid that might be on the base of his penis? He immediately goes and washed off

4)- Coming inside of me without a condom. He seems to think, theoretically that if he inserts himself inside of me right before he`s ready to come, he may not get infected, as noting can go in , if something is coming out? I asked my doctor about it and he wasn`t sure.

5)- putting his penis next to my vagina when we sleep. Is it okay, for him to put his penis, without a condom on, very close to my vagina while we're together? Like between my legs pressing against my clit and vagina?

6)- Oral sex my viral load undetectable , T-cells currently at 1100, is it safe ? what`s the real vs. theoretical risk?

7)- Cut vs. uncut --I`ve heard so many differnt things. Is "cut" safe or less likely to get HIV through unprotected sex?

Answer:

You post a several questions, so I am going to splice my answer in between them. As a preamble, there are no "100% safe" or "100% risky" practices related to HIV transmission. HIV transmission risks is a question of degree and to certain extend chance, but repeatedly taking chances increases the probability of transmission.

Thank you so much --your the greatest- and I really, really need your help. Questions: I`m a postitive female,

In General, Female to male transmission is less effective than male to female transmission.

my man is negative I love him very much and want to save this relationship, here are some of my questions 1)- going down on me(cleaning up) after I urinate, how risky is that?- I`ve heard drinking urine is fine so is licking up was ok? Urine contact with his mouth and vaginal contact with his mouth (mucosa) carries risk of HIV transmission. 2)- masturbation by my partner .. is it safe for him to play with me , with his hand even though there are vaginal fluids involved?

It is safe, as long as your partner does not have open cuts in the skin of his fingers and around finger nails

3)- we practice safe sex, but does he need to worry about coming in contact with my vaginal fluid to remove the condom or any vaginal fluid that might be on the base of his penis? He immediately goes and washed off.

Safe sex, in the sense of intercourse using condoms, is considered safe. Contact of vaginal secretions with intact skin (NOT MUCOSA) the mucosal surface of his penis is considered safe

4)- Coming inside of me without a condom He seems to think, theoretically that if he inserts himself inside of me right before he`s ready to come, he may not get infected, as noting can go in , if something is coming out? I asked my doctor about it and he wasn`t sure.

This practice carries some risk. His penis mucosa is in contact with you vagina. Small cuts and abrasions resulting from the sexual act itself are common portals of entry for HIV infection. HIV is not acquired by the virus making its way up the urethra, which is the concept that your partner seems to hold.

 5)- putting his penis next to my vagina when we sleep.. Is it ok, for him to put his penis, without a condom on/ very close to my vagina while whered together? Like between my legs pressing against my clit and vagina?

Carries some risk. His mucosas (wet surfaces) are in contact with yours.

6)- Oral sex my viral load undetectable , T-cells currently at 1100, is it safe ? what`s the real vs. theoretical risk?

It is believed that the lower the viral load, the lower the risk of transmission. This information comes from our experience with HIV positive mothers transmission to their offspring. However, occasionally a woman with undetectable viral load transmits HIV to the baby. We do not know if contact with a person with an undetectable viral load is completely safe. Viral load measure the virus free in the plasma, but some of your cells, harboring latent virus may find its way into your partner's system and transmit the infection. Oral sex, because contact of your vaginal mucosa and his oral mucosa or his penile mucosa with your oral mucosa is considered risky. Use of barrier methods is recommended.

7)- Cut vs. uncut --I`ve heard so many differnt things...is "cut" safe or less likely to get HIV through unprotected sex?

In some studies, Circumcision modestly decreases the risk of transmission, but I just do not believe it has any major effect.

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Response by:

Francisco   Gomez, MD Francisco Gomez, MD
Assistant Professor
College of Medicine
University of Cincinnati