Anonymous on August 9, 2011

My partner has HIV...what’s my risk?

The woman I love has HIV, but I’m very confused. She says she doesn’t have AIDS, only HIV. What’s the difference? I had sex with her once and oral sex many times. I really love her, but I’m also afraid. Can I tell her that I want to stop having sex without hurting her? What are the chances I’ll get HIV from oral sex?

answered by Eric Christoff, MD, AAHIVM on August 9, 2011

I’m sorry to hear about your distress. You’re not alone in wondering how to best protect yourself when you are in a committed relationship with an HIV-positive partner. I’ll take your questions one at a time, starting with the difference between HIV and AIDS.

What’s the difference between HIV and AIDS? HIV is a sexually transmitted disease that causes a person’s immune system to break down, making it easier for them to catch other infections. HIV is the virus that causes AIDS…but not everyone who has HIV will get AIDS.

AIDS is a life-threatening syndrome that further diminishes the body’s ability to defend itself from diseases and infections. But with proper care and treatment, it can take more than 10 years for an HIV-positive person to develop AIDS. And some never do.

HIV is not curable, but it’s treatable. Today’s HIV treatments slow down the effects of HIV on the immune system, making it less likely that an HIV-positive person will get AIDS or another infection. Many HIV-positive people live long, active lives.

And research on new HIV treatments continues every day. Currently, highly active antiretroviral therapy (HAART) helps people with HIV to maintain a good quality of life for as long as possible.

Can you get HIV from oral sex? Yes. According to the Centers for Disease Control and Prevention, evidence suggests that the risk of getting HIV from oral sex is lower than from vaginal or anal sex…but it’s still possible to get HIV from oral sex. You can reduce your risk by always using a condom or a dental dam, and making sure that neither of you have open wounds in your mouths or on your genitals when you have sex.

What about vaginal sex? One study from the University of North Carolina suggests that, for every 100,000 times a man has vaginal sex, 6 of those times will result in infection. If you do choose to have vaginal sex, using a condom every time will lower your risk substantially.

You should also be aware anal sex puts you at the highest risk of getting HIV. The mucosal surfaces inside the anus, as well as the likelihood of a condom tearing, make anal sex a high-risk behavior for anyone having sex with an HIV-positive partner.

Is your partner being treated for HIV? HIV treatment not only helps protect your girlfriend from other infections, it also reduces her risk of her spreading the disease to you.

HIV treatment reduces the amount of viral load (how much HIV is in your girlfriend’s blood). The less viral load a person has, the less likely they are to spread HIV. Reducing viral load does not mean you have no risk (and you should still use a condom or dental dam every time you have sex)… but it does help lower the risk.

While there’s no guarantee that you won’t get HIV from an infected partner, knowing your risks, using latex condoms or dental dams every time you have sex (oral, anal or vaginal), and making sure your partner is being treated by a doctor can all help reduce your risk of getting HIV.

It’s time to have an honest, loving conversation with your partner. It’s obvious that your partner’s feelings are important to you and that you love her. You want to be safe, but you also want to take care of her. If you choose to continue the relationship, it’s important that the two of you learn to have open, honest conversations about HIV.

If you’re nervous about approaching the subject of HIV and AIDS with your partner, first role-playing the conversation with a trusted friend or counselor can help you organize your thoughts and gain the confidence you need.

Make STD testing a regular part of your life. Since you’ve been having oral and vaginal sex with your partner, I recommend that you get tested for a full panel of STDs.

Why? Because HIV increases a person’s risk of getting (and transmitting) other STDs. The good news is that many STDs are easily treatable, and some are curable…but getting tested is the only way to know your STD status, and whether you need treatment.

If you continue having sex with your HIV-positive partner, I suggest you get tested every six months. If a condom or dental dam breaks, wait three months and go get tested again. If you take a look at our STD Testing Windows Guide, you’ll see that testing at three months after exposure to the virus ensures the most accurate test results. Also, new research suggests that heterosexual partners of people infected with HIV may reduce their risk of catching HIV by taking HIV medication. Talk to your doctor to find out if this is a good option for you.

If you do get HIV, you can still live a good quality of life for a long time. When properly treated and managed under a doctor’s supervision, many HIV-positive people live long, normal lives.

The important thing is to know whether you have HIV, and get treated immediately if you do. The quicker you detect and treat any STD, the better your health will be. In fact, early detection can even save your life.

For more information about HIV risks, prevention, testing and treatment, visit our Expert Guide to HIV.

Thank you for your thoughtful questions. I hope you and your partner continue to keep each other’s best interests in mind.

Related Info:

Eric Christoff, MD, AAHIVM

Dr. Christoff is a practicing physician at Northwestern Memorial Hospital, as well as Assistant Professor of Clinical Medicine at the Feinberg School of Medicine, Northwestern University. His areas of expertise include the treatment of HIV and syphilis along with other STDs, the medical treatment of depression and chronic fatigue, and the specific health needs of gay and lesbian patients. Dr. Christoff was educated at the University of Toledo, College of Medicine and completed his residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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