Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date. I am a 38 y/o HIV+ married man under medications for 7 years. CD4 1110+ and vl[viral load] undetectable. I have been very cautious in my sex life with my wife and it has been reduced to almost never. I want to rebuild my sex life with her but I have a very strong fear to infect her in any way. Recently we had our first baby through IVF and sperm wash was used. It was successful and the mother and baby are HIV-. Nevertheless I know she is very frustrated by the fact that we do not have sex at all even though I really try to explain to her that one infected person in the family is more than enough. Having an erection myself is very difficult since I am so worried about getting her infected. The use of condoms have proven to be effective and I have tried it. Is Giving oral sex to her dangerous? Is there anything else I could use or take to be able to have normal erections again and have a happy marital life? Thank you for your help!
Ross Slotten, M.D.
Klein and Slotten Medical Associates
Private Practice in Family Medicine
With a special interest in HIV disease
You deserve praise for your concern about your wife's potential risk for HIV infection. As you know, this is not always the case. It is always difficult to balance one's sexual needs with the desire to protect one's partner. But relationships often fall apart if two people are not able to enjoy a satisfying sexual life with each other, for whatever reason.
First, condoms do work. As long as they are used properly, the risk of transmitting HIV, as well as other venereal diseases, is low. So you can have vaginal intercourse if you (always) use condoms. Second, your viral load is undetectable, which significantly reduces the risk of transmission to your wife (however, it is still possible to transmit the virus through intercourse--hence the advice to always use condoms). Fortunately, oral sex is not a significant risk of HIV transmission.
Last, if you have difficulty maintaining erections, you can use one of the medications on the market that improve erectile function: Viagra, Levitra or Cialis. These drugs may interact with protease inhibitors, especially if ritonavir is part of the regimen. In that case, you would want to use a lower dose of Viagra, Levitra or Cialis.
There is no reason that you cannot have an enjoyable sex life if you're HIV-positive. Whatever you decide to do, it's important that you and your wife are on the same wavelength. If either one of you feels uncomfortable with a certain sexual practice, that must be respected, even if it seems unreasonable to the other partner.
Best of luck.
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