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Main Forums => Living With HIV => Topic started by: srmn98 on September 25, 2007, 11:26:24 am

Title: Advice for serodiscordant relationship.
Post by: srmn98 on September 25, 2007, 11:26:24 am
Hello,

I'd like to speak with others involved in a serodiscordant relationship. I'm a postive female, and my male partner is negative. We have been together for about 9 months, the relationship is strong and I love him very much.

A little background. I found out about my status last October. Since then, I have had 4 viral load tests, all of which have been undetectable. My doctor has lumped me into the Elite Controller group, although I am aware that will need years of testing to confirm this. My doctor also tells me it is unlikely that I can pass HIV on while undetectable with no medication. I guess it doesn't matter too much either way, there is always some risk.

We tried to start having intercourse (protected) a few months ago, but my partner got scared so we stopped. He started initating again this week -- which I thought was a good sign. But he admitted to me last night that he was still freaked out.

He knows that having protected sex is "safe."  But he cannot seem to wrap his head totally around things. It's difficult for me -- I'm having trouble knowing how to handle things. I am confident that we can have a healthy sexual life without putting him at risk. But ultimately, it is his choice and I don't want to try to convince him, I want him to make his own decision.

I guess I'm just feeling a bit contaminated today -- as though things will never be quite right again. While I am handling my status, I am having a really hard time with his apprehension. It's really sad. For all of the ways we can continue on with HIV, for all of the knowledge we have, I'm just really  sad for the loss of a "normal" sexual life with the man I love. And then I enter into the other questions -- if he really loved me would he be less freaked out ? How long will it take for him to accept my status -- if ever ? Is dating even worth it anymore ? I'm just so tired of thinking about HIV. And then, I feel like an asshole even complaining given my "good" health.

Just needed to vent I guess. I'm coming up on my one year anniversary of finding out my status and it must be coming up emotionally.

Sara


Title: Re: Advice for serodiscordant relationship.
Post by: emeraldize on September 26, 2007, 08:44:25 am
Good Morning Sara

I hope someone comes on and answers your questions from their experience in a serodiscordant, hetero relationship. I'm quite interested as I'm in the early days of one that's in the hand-holding/hug/kiss phase.

I do want to note that you need not ever feel like an "asshole" for complaining given that right now, one year into this, you appear to be an Elite Controller. There are no guarantees of status, of course, but I'm glad for you and it's okay for you to be glad for you.

Are you involved in any LTNP research?  If not, it can be done long distance. It's easy to participate in Dr. Walker's study at Harvard. They'll FedEx vials to your doc's office and pick up the shipping costs to send it back. You sign a waiver. Voila!

Being involved in research helps you deal with how weird it can feel to have the virus, but not be on meds, not be suffering. For LTNPs, the mental/emotional trip can be a mindf**k.

Anyway, best of luck. I'll be looking for your future posts and hopefully, replies to this one.

Em
Title: Re: Advice for serodiscordant relationship.
Post by: srmn98 on September 26, 2007, 10:50:21 am
Hi Em,

Thanks for your kind words. Yes, I am hoping to connect with somebody with a similar experience.

And yes, I am in the process of enrolling in Bruce Walker's study. My doctor here is in the process of partnering with Dr. Walker -- he tells me to be patient and that he will call me within the next few weeks or months to arrange a blood draw. I'm anxious to be a part of the study, and also curious to find out if I will be able to get any results back about the gene mutations -- or if the blood just goes into the study and I don't hear anything back.

Thanks !

Sara

Title: Re: Advice for serodiscordant relationship.
Post by: jonny123 on September 26, 2007, 02:26:24 pm
Hi Sara,

Hopefully my experience will be of some help since I am a gay man.  My partner is HIV negative and we have been together for almost 2 years.  I told him on our second date and he has been a trooper ever since.

everyone is different so I can't make assumptions of what I think your boyfriend should or shouldn't be doing but education is the key. I simply can't stress that enough

From almost day one my partner called his doctor and discussed the risks of dating someone HIV+. I remember him coming to my apartment with pamphlets and articles and all kind of information pertaining to HIV.  I think he might be more informed than me.  :-\  He definitely had concerns, but all is good now. It's a non-issue. We use protection while having sex and moved on with our lives.

If you haven't already include him on the study you are participating in with Dr. Walker. Ask him to come with you to appointments. If he isn't taking the initiative to educate himself, take him by the hand in a sense, and help him get to a place where he is comfortable.  It might take some time but if you feel this relationship is worth it take all the time you need.

Now, his concerns might be more long term maybe where having children are involved.  Have you two spoke about this?
Keep an open dialogue between the two of you so your concerns are always clear and where there is no guessing about what the other is thinking.

I hope I have helped a little...

Best of Luck
JP
Title: Re: Advice for serodiscordant relationship.
Post by: DanielMark on September 26, 2007, 03:48:51 pm
I agree! Education is the only solution to unrealistic fears and worries, Sara.  Both my ex of ten years and my current boyfriend of three were HIV negative when we met and they still are.

Daniel
Title: Re: Advice for serodiscordant relationship.
Post by: HealthyMomma on September 26, 2007, 04:20:29 pm
Hi Sara. I have been with my fiance for 2 1/2 years. I am poz, he is neg. He never really acted too freaked out by it all but I can totally see how someone would be. I think that if I was negative and some guy told me he was poz I would probably be scared too. I dont think that its a matter of how much he loves you, but how much he understands. It could take awhile. Has he ever been to the doctor with you? If not, maybe it would be good for him to go and be able to talk to docs and ask questions. My fiance has went to the last 4-5 appointments with me and I think that now he is really understanding alot more. I wish you luck! ~Nicki
Title: Re: Advice for serodiscordant relationship.
Post by: Moffie65 on September 26, 2007, 04:37:41 pm
I would like to give some pointers from my perspective as being in a serodiscordant relationship, but it appears you are seeking advise from heterosexuals, so I will abstain.  I have been HIV+ for 24 years, and have been in a +/- relationship for 19.

If you want to know more, please let me know.  Remember, sex and the virus know not whether the host is straight or gay.

Love,
Title: Re: Advice for serodiscordant relationship.
Post by: srmn98 on September 26, 2007, 05:01:10 pm
Thanks everybody for your words. You are all correct - I do need him to come to the doctor with me ... I have mentioned it several times hoping he would take the initiative, but I suppose the ball might be in my court to take initiative.

Tim --  I of course would love to hear anything you have to say. I'm interested in everybody's experience, not just heterosexuals. I didn't mean to sound that way when I said I am looking for people with "similar experience," I guess I meant "similar" as being in a serodiscordant relationship - straight or gay. There are some issues of transmission (i.e. mother child, male to male oral sex versus female to male oral sex) that may be specific to different situations, but my question is more an overall concern of how to help my partner get educated.

Thanks, hope to hear from you.

Sara
Title: Re: Advice for serodiscordant relationship.
Post by: Moffie65 on September 26, 2007, 05:27:15 pm
Thanks Sara,

I agree with all the others when they state that education is utmost in bringing peace to the relationship.   While encouraging, this statement in your initial post, "My doctor also tells me it is unlikely that I can pass HIV on while undetectable with no medication." does not deny that infection is still a risk and I wouldn't place a bet on it at all.  I also must confess that we have not always played safe, but have for the most part.  He is still not positive, so it comes down to a crap shoot even in the best of situations.  The only way to be sure is to always use protection, and if you really want kids together it is prudent to use a "turkey baster" so to speak. 

Now, for the nitty gritty of sex play.

First off, oral has proven to be one of the most safe of play, even unprotected, but the risk is still present, and if you have any infections in your mouth, wait until they have passed.

There are so very many ways to play safe, and still be very satisfying to both parties, but I will not go into detail as there are a million porn sites that will show all you need to know.  I would suggest that the risk is also reduced somewhat if he is circumcised already, but if he is not, I wouldn't suggest it as you are both intelligent enough to avoid infection. 

When it really comes down to it, sex is only a minimal part of a healthy relationship, when you weigh out all the time one spends with a partner, and so each couple must sit down and talk out in very detailed conversation, what each one expects out of the relationship.  Your hearts and the bind that comes from your head and emotions is so very much more important, and the physical contact and intercourse is only a bit part in that whole equation.  I would encourage you to help him understand in totality what is actually happening in your body with the virus, and encourage him to be a participant, rather than a spectator.  It will take time, and on the down side, even after 18 years I still have feelings of "contamination" and I have no idea just how to circumvent this one except to keep your self image healthy and strong.  You are NOT HIV, but it is now a part of you for the rest of your natural life, so coming to peace with that one is tantamount to building a good relationship and life.  Try to come to a place where you embrace this damn bug, and accept that it will be a part of you forever.  This will help with this relationship, and if this one doesn't work out, God/dess forbid, the next one.  You sound young, so you have a lot of life ahead and acceptance will also help your boyfriend to come to peace with it.

Also, go to your local ASO and grab all the condoms of every type you can find.   The ones that glow in the dark are really a blast on a cold winters' night, and the glow effect can rub off, so comedy is also included with these.

Just remember, sex is fun and should always be done with great glee.  Doesn't matter if you are HIV+, just keep plenty of stuff by the bed to keep things interesting and safe.  (or the kitchen or bath if that is your thing)

Hope this helps.

Love,

Title: Re: Advice for serodiscordant relationship.
Post by: Movingon on September 27, 2007, 12:35:52 am
Hi Sara

I am male , hiv positive, and my wife is negative. We have only been married for 4 months, and i tested positive 6 weeks in to our marriage. We had a fantastic sex life before my diagnosis, we didn't have sex for 2 weeks after i got the test result, and now we are back to having a great sex life again, with protection of course.

Its not easy, i have to admit. I dont like putting a condom on , and i know that she would prefer i didn't have to either, but after some time, you DO get used to it and it becomes 2nd nature . With lube and the right condom, i have to be honest and say that i can hardly tell the difference.

My wife was never freaked out with me , she is fine with it and we talk about things. Its actually ME who is more freaked out than her, as i am the one who feels dirty, and contaminated. Again, give it some time , and if you both love each other, you WILL get through it.

Feel free to PM me if you want to talk more.

cheers
Title: Re: Advice for serodiscordant relationship.
Post by: srmn98 on September 28, 2007, 10:06:03 am
Thanks everybody --  talking to all  of you makes me feel much less alone.

So we talked -- he did say he would go to the doctor with me. I guess when we break it down, sex is complicated. I guess some of our issues are HIV related and some are not. Sorting through it all is tricky -- but I am hopeful that we will work through things with time. We are both in therapy, I think that helps.

But thanks for encouraging me to talk to him. Even though I was really sad, talking helped.

:)

Sara

Title: Re: Advice for serodiscordant relationship.
Post by: blondbeauty on September 30, 2007, 01:21:17 pm
Say yes to life and yes to love!
http://www.youtube.com/watch?v=8LxEtaIzMvc&mode=related&search=
Title: Re: Advice for serodiscordant relationship.
Post by: Ann on September 30, 2007, 02:09:52 pm
Hi Sara,

I meant to chime in earlier, but lost the post I wrote (while we were having trouble with the forum software) and I haven't had the chance to try again until now.

I'm the positive half of a serodiscordant relationship. We've been together over eight years now and he's still negative, despite the fact that we didn't use condoms for the first year and a half. (Before I got my diagnosis)

As long as you two are using condoms, you shouldn't have any worries. Read through the three condom and lube links in my signature line so you can make sure you're using them correctly, as a correctly used condom rarely (if ever) breaks. You might like to look at them together and there's even a video available on the first website.

You might also want to check out the information on the female condom (http://www.aidsmap.com/en/docs/6B8B1AB3-6C46-4EE2-9C34-9D53DF3ECE3E.asp). They're a little fiddly to use at first, but they're not really any more difficult than using a tampon.

Even having him go down on you is not going to result in him getting infected. Hiv transmission doesn't stand a chance of happening via female genitals to mouth - there are just too many obstacles on the oral route.

The first obstacle is the mouth itself. The mouth is a veritable fortress, standing against all sorts of pathogens we come into contact with every minute of our lives. It's a very hostile environment and saliva has been shown to contain over a dozen different proteins and enzymes that damage hiv.

Hiv is a very fragile virus - literally. Its outer surface doesn't take kindly to changes in its preferred environment; slight changes in temperature, moisture content and pH levels all damage the outer surface. Importantly, it needs this outer surface to be intact before it can latch onto a few, very specific cell types and infect. 

Which leads to the second obstacle. Hiv can only latch onto certain types of cells, cells which are not found in abundance in the mouth.

The third obstacle to transmission this way is having hiv present in the first place. The female secretion where hiv has been shown to be present is the cervicovaginal fluid. This fluid is actually a thick mucus that covers and protects the cervix.

The fluid a woman produces when sexually excited comes from the Bartholin's glands (http://en.wikipedia.org/wiki/Bartholin's_gland), located on either side of the vaginal opening. I have yet to discover one shred of evidence (and believe me, I've looked) that shows this lubricating fluid to have any more hiv present than other bodily secretions such as saliva, sweat or tears. Saliva, sweat and tears are NOT infectious fluids.

So there you have it. Once the results of the serodiscordant studies started rolling in, what we know about hiv transmission on the cellular level was validated. The only people who were getting infected were those who had unprotected anal or vaginal intercourse. Period. One of the three studies went on for ten years and involved hundreds of couples. That's a lot of nookie.

If you aren't familiar with the serodiscordant couple studies, here's the results in a nutshell:

There have been three long-term studies of serodiscordant couples. In the couples who used condoms for anal or vaginal intercourse, but no barrier for oral activities, not one of the negative partners became infected with hiv. Not one.

Condoms during intercourse are the key to making sure your partner stays hiv negative. They really do work.

Ann
Title: Re: Advice for serodiscordant relationship.
Post by: srmn98 on September 30, 2007, 02:21:48 pm
Hi Ann,

Thanks for your response ...  and just to clarify, the studies on oral sex you are referencing are a male performing oral sex on a female, and not the other way around, correct ?  I always used condoms (yes, correctly-- I always checked for breakage after) for intercourse, so I can only assume my route of transmission was through giving a blowjob. This freaks my partner out a little bit -- we are being "safe" in the same ways I was always "safe" -- but somehow I still ended up HIV poz.

I think I've asked you before-- any luck on finding the specific studies on serodiscordant couples ? Referencing them helps, but I would really like to see the information first hand.

Thanks so much, Ann -- your information always helps. :)  And It helps to hear your story too.

s

Title: Re: Advice for serodiscordant relationship.
Post by: jkinatl2 on September 30, 2007, 02:53:17 pm
Sources for Ann's assertions include:

Oral Dis.   2006   May   ;12   (3):219-28 16700731   
Oral transmission of HIV, reality or fiction? An update.
J   Campo , M A   Perea , J   Del Romero , J   Cano , V   Hernando , A   Bascones
Human immunodeficiency virus (HIV) and many other viruses can be isolated in blood and body fluids, including saliva, and can be transmitted by genital-genital and especially anal-genital sexual activity. The risk of transmission of HIV via oral sexual practices is very low. Unlike other mucosal areas of the body, the oral cavity appears to be an extremely uncommon transmission route for HIV. We present a review of available evidence on the oral-genital transmission of HIV and analyse the factors that act to protect oral tissues from infection, thereby reducing the risk of HIV transmission by oral sex. Among these factors we highlight the levels of HIV RNA in saliva, presence of fewer CD4+ target cells, presence of IgA antibodies in saliva, presence of other infections in the oral cavity and the endogenous salivary antiviral factors lysozyme, defensins, thrombospondin and secretory leucocyte protease inhibitor (SLPI). Oral Diseases (2006) 12, 219-228.

http://www.aidsmap.com/en/news/2AF5DF5C-ECEF-4854-80BA-09F86B483A02.asp

http://gateway.nlm.nih.gov/MeetingAbstracts/102255339.html

The Romero study used male/female relationships almost exclusively, with either male or female partner positive. The viral loads varied widely, as did the treatment options (or lack thereof) during the ten years of the study.

The Page-Shafer "HOT" study used homosexual males with different partners, studied both receptive and insertive oral sex.

The abstract of the study is also here:

http://www.aegis.com/conferences/iac/2002/TuPeC4872.html

An updated abstract of the Romero study is in:

Oral Dis.   2006 May   ;12   (3):219-28 16700731

An earlier Page-Shafer study regarding oral HIv transmission:

Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men.
AIDS. 16(17):2350-2352, November 22, 2002.
Page-Shafer, Kimberly a,b; Shiboski, Caroline H b; Osmond, Dennis H c; Dilley, James d; McFarland, Willi e; Shiboski, Steve C c; Klausner, Jeffrey D e; Balls, Joyce a; Greenspan, Deborah b; Greenspan, John S b

Other relevant studies, many of which reference either/both Romero and/or Page-Shafer, among others:

http://www.aidsonline.com/pt/re/aids/fulltext.00002030-199904160-00021.htm;jsessionid=G1nGq7PY37yynzdYy7CHvpqRwHKzNFS7J3gPvGYzGKp6Tz2nvFdx!1330140564!181195629!8091!-1?nav=search&searchid=1&index=21&results=1&count=10

Note the methodology for the Page-Shafer and Romero studies, and how they differ significantly from earlier studies which relied on post-infection patient report. In my opinion, that methodology dramatically increases the validity of the report.




PS: I am aware of the hornet's nest I am stepping close to here. Please understand that I shan't step in.

Title: Re: Advice for serodiscordant relationship.
Post by: blondbeauty on September 30, 2007, 04:50:39 pm
That study is made by Jorge del Romero. He is teh director of the Sandoval Clinic where I was diagnosed in Madrid and author of the study about natural conception in serodiscordant couples I posted a few days ago:
http://www.elpais.com/articulo/salud/terapia/antiviral/reduce/riesgos/concepcion/natural/parejas/VIH/elpepusocsal/20060314elpepisal_7/Tes