Loving in a Dangerous Time

Housecall with Dr. Denise
urban NDN - June 2008 - issue 1

Tansi! I’d like to share some health questions I’ve come across and my responses. If you have any health-related questions, please feel free to contact me at the information below.

I just learned that someone I fooled around with a few months ago is HIV-positive. What kinds of activities are risky? What should I do?

You can get HIV if the virus gets into your bloodstream from another person who is infected with HIV. It can enter your body through the infected person’s semen, vaginal fluid, or blood.

The Canadian HIV/AIDS Information Centre ranked activities as:

No risk: To our knowledge, none of the practices in this group has ever lead to HIV infection. There is no potential for transmission since none of the basic conditions for infection are present. This category includes fantasizing, h and holding, phone sex, mutual masturbation, bubblebaths, sensual touch and massage, cybersex, masturbation, hugging, watching erotic videos, dry kissing (no exchange of saliva), unshared use of sex toys, getting the person’s feces or urine on the body.

No real risk: The practices in this category present a potential for HIV transmission because they involved an exchange of body fluids (such as semen, vaginal fluid or blood). However, the possibility of HIV transmission appears to be unlikely. There are no confirmed reports of infection from these activities. This category includes wet kissing (saliva exchanged), receiving fellatio (blow job, getting head), receiving cunnilingus (eating out), giving anilingus (rimming, licking ass), giving or receiving digital/manual intercourse (anal or vaginal fingering or fisting), sharing sex toys with a new condom or disinfected and rinsed, getting the person’s feces or urine into the body.

Low risk: The practices in this category present a potential for HIV transmission. There are also a few reports of infection attributed to these activities: giving fellatio or cunnilingus, receiving anilingus (rim job), vaginal intercourse with a condom, and anal intercourse with a condom.

High risk: Practices in this category present a potential for HIV transmission and there are a significant number of scientific studies that associate these activities with HIV infection: shared sex toys, vaginal intercourse without a condom and anal intercourse without a condom. Any activities that involve drawing blood or break the skin, such as body piercing and tattooing, are high-risk activities that require sterile precautions, i.e., new needles, new ink, proper after care and sterilization every time. These precautions will probably not be available to a do-it-yourselfer or may not be adhered to by less reputable establishments. You should seek out professional technicians who adhere to proper sterilization and safety procedures.

Use of condoms with Nonoxynol 9 (a chemical that kills sperm and prevents pregnancy) is considered risky, because the harsh chemicals in it can damage the lining of the vagina or rectum and provide a transmission route for HIV.

There is a “window period” of three to six months between the time a person is infected with HIV and the time that they will test positive for HIV antibodies. It is during this window period that a person is most infectious and most likely to infect someone else, because they do not know they are infected.

Therefore you should:

Get tested for HIV and all other STIs, and get treated accordingly. Get tested periodically, because earlier detection leads to better outcomes.
Avoid sexual activities until at least 3 to 6 months after your HIV test.
To prevent the exchange of bodily fluids, avoid contact between bodily fluids and you or your partner(s) mouth, vagina, anus, penis, or an open cut or sore.
Practice safer sex.
Use a condom—it substantially reduces the risk of infection if you are giving or receiving. Remember, though, that condom use does not remove the risk of STIs—including HIV, genital warts, syphilis, herpes; condoms just decrease the risk substantially. Abstinence is the only surefire way to remove the risk.
Use a water-based lubricant—it increases your stimulation and decreases the risks.
Reduce the number of sexual partners.
Get the facts—talk to your doctor and keep informed about your health!