QUESTION
I've started seeing a guy, definite relationship-material here. I have been HIV+ for nearly 20 years and I don't know his HIV status. I'm assuming he is negative. I've had the talk in previous dating relationships and feel it is time to have the talk with this man. I haven't had a date with someone in a long time, 4 years to be exact, and I'm feeling rusty and out of practice about approaching the topic. I am in excellent health and wouldn't want to do anything to put his or my health at risk. Do you have any advice other than straight-forwardness and keeping to the facts?

ANSWER
Disclosing your status to a new partner is one of the hardest things to do, but has tremendous benefits. It is wonderful that you are considering your own health -- because new STDs can increase viral load and decrease CD4 counts in persons with HIV -- and your partner’s health -- trying to help him stay negative.

Different strategies work for different people. Find a good time when you won't be interrupted -- in the car, before dinner, in the morning -- but not in the throes of passion. Don't delay while waiting for the best moment, because no time will likely be easy. You can start off by telling him how you care about him and have something important to talk about. A good friend or new lover will be impressed and honored that you care about them enough to be forthcoming and direct about such an important issue. For more advice about talking about HIV with your partners, click here -- good info from the San Francisco HIV Disclosure Initiative.

Remember there are other STDs out there in addition to HIV, so both of you should get a complete STD/HIV check-up and until then practice safer sex, including condom use for anal sex. Congratulations on finding your special someone, and kudos for being responsible to the community.

To your health,
Dr. K