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Friday, May 02, 2008

Question

My lover is HIV-positive. (We are a straight couple.) I haven't told a lot of people because he prefers to keep his status private. So far, he is in pretty good health, but there are times when I wish I could talk about how it makes me feel to know that he has an illness that might kill him. But I know that my family would urge me to leave him. They would also suspect him of being gay. My friends are not that backward, but they wouldn't understand how I could fall in love with somebody who is positive. And after what happened this weekend, they will want to kill him.

Our safer sex lovemaking has evolved the longer we've been together. First we didn't do any penetration at all. Then we felt we were really missing out on a bonding experience. (I just couldn't take it. I wanted him inside me.) So we used condoms, and he didn't come inside of me. But then the condom use felt good and seemed very safe, and so I told him one day to go ahead and come without pulling out. I wanted him to experience complete fulfillment in my arms. It felt so good to just hold him and let him have that release. I came too, by the way.

What happened the last time we fucked, is he came, and then kept on fucking me. As he lost his erection, the condom lost traction, and came off inside of me. By the time he realized what had happened, and I had retrieved the lost condom, there was a lot of semen in my vagina.

We went to the emergency room, and after waiting for a long time and getting a lot of crappy attitude, we were sent to a clinic where we saw an HIV specialist. He put me on medication and drew some blood to test me for STDs. He wasn't mean to us at all; just encouraged us to be more vigilant. I have to go back in a month to be tested, and then six months after that.My emotions are running the gauntlet. I get scared, I cry, I'm sad for him and sad for myself, I'm angry with him for not keeping track of that damn condom, and I'm very angry with him for getting infected in the first place. He's withdrawn, but I don't know if I want him to try to comfort me. The only thing he's said is that he's afraid I'll leave him. He's said this several times, and I don't know what to answer, because there is a part of me that does want to leave.

How do I take care of myself? What should I do about him? Will I ever want to have sex with him again? If I'm 100% honest, I have to admit that I'm furious with myself too. Why did I feel that it was okay to let someone with this virus stick his dick in me? Why did I let him get off without pulling out? What is wrong with me? Do I want to be sick too?Please help me sort this out. There really is nobody I can talk to.

Answer

I don't want to call you "fucked" because you already feel enough self-reproach and despair without me calling you names. Couples who are both HIV-negative (or think they are) do the same thing that you did all the time. They don't call it "criminal" or "careless" or "pathological." They call it "making love." Of course you wanted the man you loved to be as close to you as possible. You have a right to your own pleasure, and of course he wanted to make you happy. I'm very relieved to hear that you knew about prophylaxis and got the medication. Many women would have thought of it or wouldn't even know about it. It's not just for men who have sex with other men. Like the morning-after pill, taking anti-HIV meds after exposure is an important backup in case safer sex practices fail. There is a very good rate of success.

You've got a stressful six months to get through. I suggest you make it a priority to lower your stress as much as possible. This is a bad time to move, get a new job, etc. If you find that you are obsessing and your anxiety is making it hard to pursue normal activities, talk to the doctor again and see if you can take a short term course of anti-anxiety medication. You may not have to take it all the time. He or she can probably give you something you can take only when the anxiety exceeds manageable bounds. Remember that it is much easier for HIV-negative men to get the virus from HIV-positive women than the other way around.

As soon as you think you can mange it, talk to your partner. Insist that he listen and open up to you. Don't feel that you have to make any false promises about continuing the relationship. It really is in crisis right now. The reality of being with someone who has a transmissible, life-threatening injury has hit home. We're all going to pass through the gateway of death, but it's no fun at all to see it looming. If you're going to stay together, the two of you need to share a full range of reactions—the sadness, anger, fear, and self-doubt. Venting is the best thing you can do. Don't feel that you have to solve the problem. You've done all you can about it for now. But do listen. There's nothing wrong with having the same conversation more than once. You've both been traumatized, and repetitive talking is often therapeutic.

If you want to be sexual, go back to the strict safer sex precautions. Don't throw up your hands and say, "Oh, well, I've been exposed. Who cares? Might as well go for the big gold ring." You may not want to be fucked by a cock at all. He can use his fingers or a dildo if you want penetration. But if he does begin to fuck you again, don't just lay back and get lost in the sensations. Take responsibility for checking the condom from time to time. I hope he understands now that he needs to do that too. And after coming, he needs to withdraw, holding on to the base of the condom to keep it from getting lost inside of you. No more thrusting as his penis is getting softer and the condom is coming loose!! If lovemaking is prolonged, switch to a new condom to make extra sure nothing breaks.

Try to remember why you fell in love with him in the first place. These are good stories to share with one another. Do you still believe he is that person you got a crush on? Maybe he's even better than that first impression. If so, maybe this is worth holding on to. How often does love come along? You could fall in love with a diabetic, someone who went on to get cancer, or a person with clinical depression. No one would condemn you for that. But don't stay with him just because you think he needs you, or you feel you should take care of him. He doesn't need your pity. And a relationship based on such sentiments will quickly grow bitter and distant.

Many issues arise between sero-discordant couples. I'd urge you to seek out a support group, but most AIDS prevention agencies only provide such services to male couples. Nevertheless, it doesn't hurt to phone around and ask. A couples counselor could help, or an individual therapist. HIV-negative people do ask themselves why they chose such a relationship, whether it's good for them, and also if they have an unconscious desire to be like their HIV-positive partner, to share their situation and also remove the barrier of safer sex. Sometimes these questions can't be shared immediately with a partner, but have to be examined with a neutral and supportive third party so you can get more clarity.

Make self-care a priority, and buy a lot of mystery novels or whatever escapist form of entertainment you prefer. Please feel free to keep in touch with me by e-mail. I am concerned about you, especially because of your isolation.