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HIV and AIDS

Can I Have Sex With My Husband After A Positive HIV Diagnosis?

03/17/2006

Question:

I found out a year ago that my husband is HIV posititive. Can I have sex with him?

Answer:

We have known since early in the epidemic that unprotected sex can transmit HIV. Worldwide most new infections result from sexual transmission, but not all sexual practices are equally likely to result in HIV transmission. It is impossible to precisely estimate the individual risks of each sexual act.

The likelihood of transmission depends greatly on the chance that a partner carries HIV, the stage of that person's infection, and the presence or absence of other sexually transmitted diseases. Although much is still controversial, we do know that:

1. HIV is commonly transmitted sexually by penile-anal intercourse. The receptive partner (bottom) is at much more risk, but the insertive partner (person putting his penis into the anus) can also get infected.

2. HIV is commonly transmitted sexually by penile-vaginal intercourse. The female is at more risk, but the male partner also can get infected.

3. HIV can be transmitted by oral sex. Oral sex is much less risky than anal or vaginal sex.

4. Other factors can affect transmission risk: the presence of other sexually transmitted diseases (STDs), viral load, condom use and douching.

Data defining how risky each individual sex act is are not very useful, but we can say that certain sexual activities are more risky than others. The presence of another STD greatly increases the risk of transmission. A high viral load increases the risk of transmission. Persons with very low or undetectable viral load can still transmit. Douching increases the risk of transmission. Correct and consistent condom use greatly decreases the risk of transmission.

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Response by:

Pamposh   Kaul, MD Pamposh Kaul, MD
Assistant Professor
College of Medicine
University of Cincinnati