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Ask Dr. K
HIV+ FRIEND GETS ORAL WITHOUT DISCLOSING

QUESTION
A very good friend of mine who is HIV+, with a very high viral load not treated yet due to high CD4, has been engaging in active sexual relationships with strangers, i.e. he allows guys to give him oral sex -- fortunately, that is all he does. I feel upset that he does not disclose his HIV status to those he engages in sex with. I wish he understood that there's an urgent need to stop the spread of HIV. By disclosing his status, the guys whom he engages with would be aware of the risk they are taking. What is the best way to tell him my concerns without destroying our relationship?

ANSWER
It is always difficult when friends have different opinions and engage in activities with which we may not agree. It is a risk to talk about your feelings and how his actions make you feel. You can try to explain this. But in the end, to keep your friendship, you may have to respect his feelings and the fact that he and his sex partners have made choices about how they will act together. Most men who engage in oral sex and do not discuss their status are aware of the fact and may have decided that oral sex is a low risk activity and are not concerned about transmitting HIV.

For your own information, oral sex is considered an extremely low risk for HIV transmission, but there are rare reports of it. Your friend may have other STDs such as gonorrhea, chlamydia, and syphilis which are transmitted via oral, anal, and vaginal sex. To find out more, our STD charts indicate the risks associated with different sexual activities. You could casually refer your friend to the STD charts as a gesture of sharing information.

To your health,
Dr. K


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