Welcome, Guest. Please login or register.
March 29, 2024, 12:40:56 am

Login with username, password and session length


Members
  • Total Members: 37614
  • Latest: bondann
Stats
  • Total Posts: 772947
  • Total Topics: 66310
  • Online Today: 332
  • Online Ever: 5484
  • (June 18, 2021, 11:15:29 pm)
Users Online
Users: 0
Guests: 333
Total: 333

Welcome


Welcome to the POZ Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Do I Have HIV?” posting guidelines. Click here for posting guidelines pertaining to all other POZ community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: Sero-discordant relationship  (Read 2461 times)

0 Members and 1 Guest are viewing this topic.

Offline wonderboymi

  • New Member
  • Posts: 1
Sero-discordant relationship
« on: April 26, 2013, 04:06:22 pm »
Hi everyone; I'm not sure the best place to post this question so I thought here would work  ;)

I've been HIV+ for 14 years now and except for a small blip twice I have been undetectable for 13 of those years.  I've never posted here, although I have read the site for years and years.  I used to be well versed on all things HIV but the first 6 or so years of my diagnosis I was unemployed and really didn't have a lot of other things to do besides read.  Moving to NYC 8 years ago put HIV knowledge on the back burner for me, but I am mostly okay with that.

My question is this.  I am currently "seeing" someone.  We're not in a relationship per se, in Facebook parlance I would say "it's complicated".  I am poz, he is not.

We've made a decision to not use condoms when we have sex with each other. (He has a few buddies he has sex with besides me).  I am generally the insertive partner although sometimes he is, and I don't ejaculate inside of him. 

I guess my question is, how unsafe is it?  I know that it's certainly not totally safe, but my feeling is that it's more like an educated safety level.  For example, it is far more risky for him to have unprotected sex with someone whom believes himself to be negative, when in actually they seroconverted recently and just don't know it  than it is with me when he can gauge the risks.

I am trying to get him to speak to my doctor or his doctor about doing PREP.

I'm not looking for an excuse to have unsafe sex, I'm just hoping someone will have some advice to help me figure out how I feel?

Thanks so much.

Offline jkinatl2

  • Member
  • Posts: 6,007
  • Doo. Dah. Dipp-ity.
Re: Sero-discordant relationship
« Reply #1 on: April 26, 2013, 06:36:37 pm »
Well, the thing is, no one knows for sure. The Swiss study, though compelling, doesn't factor in several important considerations important to your situation.

1) anal sex

2) the possibility of your partner perhaps acquiring an STD in an extracurricular activity, which could cause inflammation of and sores in the anus, thus rendering him more vulnerable to infection -

3) passing aforementioned STD to you during sex, which could facilitate a spike in seminal viral load. This, combined with a similar vulnerability in your partner's anus, could theoretically facilitate infection.


It is known that spikes in seminal viral load can and do happen, even when the blood serum remains undetectable. The studies I have read so far, however, do not say exactly what that spike WAS, but it was obviously detectable. There has also been no testing of these spikes to see how much viable virus was released, and what the tipping point for infection would be. I suspect the latter of these considerations varies tremendously in each couple, and possibly each sexual act.

It's a calculated risk, for certain. How much of one is unknown. We DO know that, as the insertive partner, the risk is greater for your negative mate than if you were the receptive partner.  How much? Hard to tell. You have introduced variables that make your situation more fluid than others.

Obviously, if your partner went on PrEP then this response would be way shorter.

In each relationship we set boundaries and establish assumed risk. Knowing that your partner has other sexual partners does open up the possibility for a more complicated scenario, as many other STDs are robust enough to be transmitted despite condom use.

There is also the factor you mention of not ejaculating inside him. While it's possible that pre-ejaculatory fluid might contain viable virus even in people with an UD VL, how much, and under what circumstances are factors for which I can't find decent answers. Again, the presence of another STD and accompanying inflammation would come into play here, but the research is pretty vague.

All I could say is that you guys are grownups and have armed yourself with the facts. Your choices are yours to make and, frankly, no one's to judge. An informed accepted level of risk is what you are basically discussing here. And the more informed you both are, the better you both will feel about it.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline jkinatl2

  • Member
  • Posts: 6,007
  • Doo. Dah. Dipp-ity.
Re: Sero-discordant relationship
« Reply #2 on: April 26, 2013, 06:39:24 pm »
PS: I never answered your question. How DO you feel?

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline weasel

  • Member
  • Posts: 1,906
Re: Sero-discordant relationship
« Reply #3 on: April 27, 2013, 11:27:05 am »

     Hi Wonderboy ,
                         Nice to meet you  :)

     I have been in a POZ - NEG   relationship now for over 30 years .
     I am undetectable  and have a 465 ?   T-cell count .
     Bob and I try to be safe  , sometimes it  does not work out that way  :-[

     I hope your relationship works out well , Knowing you have HIV is a plus .
     There are still 1,000's of guys out there not willing to find out they are POZ .

     The fact he does not seem to care tells a lot , I think .     I  always assume
    most guys are POZ , it works out better that way  ;)

                                            Be well , have fun ,
                                                                        Weasel 
" Live and let Live "

Offline Jmarksto

  • Member
  • Posts: 667
Re: Sero-discordant relationship
« Reply #4 on: April 27, 2013, 01:55:25 pm »
Hey Wonderboy;

Welcome to being active in the forums.  It seems others have answered your question, in that no one can quantify the risk.  In terms of how you feel - I think the fact that you are posting here and trying to get him on PREP, says that you would feel better if he were on PREP - the question is, how do you get him to see the benefits of PREP. 

Here is my argument for PREP:

1.) I think the vast majority (all?) of us that are poz, in hindsight would welcome the opportunity to take PREP to avoid being poz. 

2.) Even if he doesn't mind the thought of being poz, PREP would protect his buddies if they are neg, or protect him from them if they are poz. It seems like the right thing to do if his other partners are neg.

3.) Any downside to PREP is by far less of a downside to being poz. The one short term downside of PREP may be the cost of the meds - while PREP may seem expensive to a neg person, it looks pretty darn cheap to a poz person - especially if you don't have great insurance, or are at risk of loosing insurance, etc.

Those are my thoughts anyway,

I wish you well,

JM

03/15/12 Negative
06/15/12 Positive
07/11/12 CD4 790          VL 4,000
08/06/12 CD4 816/38%   VL 49,300
08/20/12 Started Complera
11/06/12 CD4   819/41% VL 38
02/11/13 CD4   935/41% VL UD
06/06/13 CD4   816/41% VL UD
10/28/13 CD4 1131/45% VL 25
02/25/14 CD4   792/37% VL UD
07/09/14 CD4 1004/39% VL UD
11/03/14 CD4   711/34% VL UD
03/13/15 CD4   833/36% VL UD
04/??/15 Truvada & Tivicay
06/01/15 CD4 1100/50% VL UD
10/16/15 CD4   826/43% VL UD
??/??/2017 Descov & Tivicay
2017 VL UD, CD4 stable around 850
2018 VL UD, CD4 stable around 850

 


Terms of Membership for these forums
 

© 2024 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.