Oral Sex and HIV
It is erroneously believed that oral sex is safe, as you cannot contract STDs by having sex this way. The truth is it is not 100% safe in protecting you from HIV. And even if you are both HIV+, it could be detrimental too (See 2. Below).
WHY IS IT NOT SAFE?
• Blood from cuts or sores. If the person giving oral sex has a cut or sores in their mouth and is HIV+, HIV can be passed to the receiver through their penis, vagina or anus. If the giver is HIV-, they could contract HIV if the receiver has cuts or sores on their genitals. Using a condom can prevent HIV transmission. You really can't be 100% certain that you do not have a cut or sore on your genitals, so it's best to be safe and use protection. Similarly, by eating certain hard foods, hot foods, cold foods, brushing your teeth and so on, abrasions are caused within your mouth, so you may have sores and not know it.
• Pre-ejaculation Fluid. Pre-ejaculation fluid also known as 'pre-cum' is the translucent-to-white liquid you see before ejaculation (sometimes before sex). Some people think you cannot get HIV from pre-cum but you CAN. This may be present during oral sex and ingestion or any other form of exchange of this fluid could result in HIV transmission if either person is HIV+.
• Ejaculation Fluid. HIV can be transmitted through 'cum' also known as ejaculation fluid. Use a dental dam (shown) for oral sex. It is a thin but highly effective piece of latex which is used by placing it over the genitals of the person receiving oral sex and has been shown to provide maximum protection against STDs including HIV. And because dental dams are so thin, the receiver does not feel as if there is a barrier between him/her and the giver.
ISSUES FACED IN HIV+ RELATIONSHIPS
1) Little (or no) sex in the relationship? Many HIV couples lose intimacy in the relationship. This may stem from the fact that they are wary of infecting one another. Some ARV medication has been suggested to cause reduced libido (sex drive), whilst for some people there is a feeling of shame associated with being HIV+ as a result of unprotected sex, and therefore they lose interest in it altogether.
You can have safe sex with a latex condom. Condoms have been shown to provide excellent protection from STDs including HIV, when used consistently and in the correct way. If you worry that the condom might slip off or tear during use, using a suitable lubricant can help to prevent this.
See How Easy It Is to Use a Female Condom
Female condoms (shown above) have been shown to reduce the risk of STDs including HIV; and they provide safe and effective use for vaginal and anal intercourse, but NOT FOR ORAL SEX!. This is especially important for women whose male partners might be adamant about not using a condom - it is essential to always have a female condom on hand for your own protection. They are easy to use and can be obtained free from some HIV clinics. Correct use does not reduce any pleasure you may otherwise get.
2) We are both HIV+. Why use a condom? The fact that you are both HIV positive does not mean you should not use protection. Doing so can be very harmful to both of you.
Let me explain. There are different strains (types) of the HIV virus. These different strains come about when sudden changes (mutations) occur to the structure of the virus. Such mutations can occur spontaneously during the course of the disease and can cause the virus to become resistant to your HIV medication - when this happens your medication is no longer effective.
You and your partner might have different HIV strains and not using protection allows the exchange of HIV strains between you, resulting in each person's medication not being effective in stopping replication of the new strain of HIV which has been introduced into the bloodstream.
Your medication becomes useless and you could both get sick. Your doctor may stop your current combination treatment regime and try another. This often comes with a bunch of unpleasant side effects and sickness, and the new combination treatment regime is not guaranteed to work.
3) We can't use protection since we are trying for a baby. Sometimes the need to have unprotected sex arises when you want to start a family.
Some people wrongly believe men cannot get HIV from women. It has been suggested that it may be more difficult for a man to get infected by a woman through intercourse because the penile opening through which the virus gets into his bloodstream is smaller than a woman's vaginal opening. However, this does not mean a man cannot get infected by a woman.
If you want to start a family and cannot afford costly clinical treatments, a cheaper and easier option is 'Home Artificial Insemination' which you can do at home and does not require intercourse. In this procedure you collect semen in a sterilized cup (shown right) and use the provided syringe to transfer the semen into the woman's vagina. However, this method is not safe if the man is HIV+, in which case Sperm Washing may be a better option. Home Insemination Kits are available free of charge at UK HIV clinics.