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Andy’s (31) question: I’ve just met this guy and he is incredible! I have an instant connection with him and I can see us living together etc. However, I am negative and he is positive. What can I do to make this safe for me and him? Obviously using condoms etc. but what about oral sex and what happens if he cuts himself or whatever. I am a little scared but I am not going to let HIV come between me and this amazing man! I just want to be more informed.

Dr Dick’s response:

Being a discordant couple does not mean that the relationship is doomed. There are a lot of very happy and ‘safe’ discordant couples out there. I usually tell people to find creative ways to keep each other fulfilled and safe. Oral sex is considered a low risk activity, but there is some risk nonetheless because of

  • the presence of pre-cum (which has been found to contain small traces of HIV);
  • the possibility of microscopic tears in your mouth (on your gums, between your teeth, under your tongue, at the back of your throat, or on the inside of your cheeks – which can act as an invitation for the infection to enter into your body); and
  • the unpredictability of reaching orgasm (he may just cum without warning giving you little time to withdraw his penis from your mouth).

The decision is yours, but I would suggest using flavoured condoms or flavoured dental dams – which can be a lot of fun. Obviously anal intercourse carries a higher degree of risk. If your partner is a top and you a bottom, be sure that condoms are used correctly and consistently and that a water-based lube is used in order to minimise friction and breakage. And if he were to cut himself somehow I would suggest that without making too much of a fuss, minimise direct contact with that area or his blood. Keep gloves, disinfectant, plasters, bandages etc nearby just for in case. It is all about learning the facts, allaying your anxiety, and enjoying each other.