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Safe sexual activities

Question: 

Hi there,

I've been dating a women for 2 months now. Yesterday she confessed to me that she is HIV+. At first I was kind of upset because she didn't tell me earlier, but on the other hand I truly like her, and I want to give this relationship a fighting chance.
For the record, we did not have sex yet, meaning oral and vaginal sex. We did engage in french kissing, and after the first month or so, she gave me a few oil massages and masturbated me several times without it going further than that. Like I said, no penetrative sex in any way up till now, and she didn't want me to give her oral satisfaction nor fingering (for the apparent reason above, I know now). I just want to make sure these activities (massage & masturbation) are safe, because I'm experiencing a cough and a sort of rash in my mouth for a few weeks now that I can't seem to get rid off.
Was I at risk somehow to contract HIV? Is there any risk it may happen under those circumstances?
I don't remember getting in contact with her bodily fluids at any given moment.
It worries me, and I'm afraid, because if you search the net, you basically freak out afterwards.
What are the really safe sexual activities for not getting HIV?
Thank you.

M.

Answer: 

Hello,

Thanks for contacting AIDS Vancouver for HIV/AIDS-related information.

First of all, I want to commend you on being empathetic and understanding of your new partner's position. HIV is still very stigmatized and many people are too scared to disclose because they fear rejection (and sadly, even violence). In a perfect world, we would all be able to disclose everything to our new partners, but unfortunately we are not there yet.

None of those activities you described place you at risk and I understand that reading online forums can add to your anxiety! But I will explain a few things to you.

The way HIV transmission works is as follows: for you to place yourself at risk, the body fluids of your partner (ie. blood, vaginal fluid, rectal fluid) need direct access to your bloodstream through an activity like unprotected anal or vaginal sex.

So this means a few things for you:

No risk: Kissing, non-insertive masturbation (no fingers or mouth inside vagina, anus, urethra), contact with feces or urine. Of course cuddling, holding hands, massage are also safe. Please note that it's very likely that your partner is very educated about HIV and modes of transmission, and will likely take precautions (as you can tell by her aversion to oral sex).

Negligible risk: This means that there MAY be a risk of transmission because there is an exchange of body fluids. However, there has NEVER been a confirmed report. These activities include receiving oral sex (i.e. she performs on you), rimming (mouth on anus), fingering, fisting, rubbing genitals. To further reduce their risk, some people also use dental dams or latex gloves for oral sex or fingering.

Low risk: Giving oral sex, vaginal or anal sex with a condom.

So why are these activities negligible or low? Because HIV transmission occurs through the EXCHANGE of body fluids, and not skin to skin contact (making masturbation a safe activity). In cases where the mouth gets into contact with genitals, we don't consider these to place people at great risk. This is because 1) the mouth is not a very efficient route to the bloodstream, and 2) saliva contains an enzyme in the blood that inhibits the production of HIV.

So then, you might ask, why is receiving oral negligible and giving oral sex is low risk? In most cases it isn't, but let's say the person performing oral sex had actively bleeding gums. Then there might be SOME risk but that still does not make it a HIGH risk.

High risk: Condomless anal or vaginal sex.

I hope this clears everything up for you. Here is another great resource: http://smartsexresource.com/about-stis/know-your-chances-0

As for your symptoms, these sound purely coincidental, as HIV has few clinically-defined symptoms. A cough and a rash in the mouth aren't symptoms specific to HIV. If you continue to feel unwell, however, please visit a doctor to rule out any other health conditions.

If your new relationship continues, it is likely that you will learn more about HIV from your partner. If she is linked into care and managing her HIV, it is likely that her viral load will be suppressed to the point that the risk of transmission is very low, regardless of what kind of sex you have. In sero-discordant relationships (where one partner is HIV negative and the other is HIV positive), thanks to advances in medicine, people in these relationships can have sex, get married, and have children with no HIV transmission occurring.

I hope I have answered your questions; however, if you have more, please don't hesitate to contact us again.

All the best,

Maggie

AIDS Vancouver Volunteer