Terrified about possible HIV transmission

Dear Terrified,

Your attention to your health and well-being will go a long way toward protecting you against sexually transmitted infections (STIs), including HIV/AIDS. The sexual scenario you described puts you at little to no risk of HIV transmission. To date, there have been no reported cases of HIV transmission from semen entering the eyes, nose, or ears. HIV cannot enter the body through the skin unless semen is deposited directly into an open wound — and even this is not a guarantee of transmission. The highest risk activities for HIV transmission include receiving unprotected anal sex from an HIV+ person and injecting drugs with unclean needles used by people with HIV. However, it is always recommended to use protective measures (such as a male condom) when engaging in other sexual activities.

But even the most aware and concerned sexually active people are not immune to getting lost in the excitement and pleasure of sex — also aptly called "the heat of the moment." Sex can be risky if you don't think about what you're doing before and when you do it, and some risk remains even if you do follow guidelines for safer sex.

There's also no guarantee that following safer sex guidelines erases pre-, during-, and post-sex anxiety about HIV transmission. There are, however, many steps you can take to reduce this concern that, for many, hangs like a dark cloud over a human experience that can be enjoyed by all who choose to have it. Here are some suggestions:

• Plan ahead: Before having sex, go over with yourself and your partner what you will and won't do (i.e., you will kiss, receive oral sex without a condom, and masturbate each other, and you won't bite, ejaculate in your partner's mouth, or give and receive anal sex without a condom).
• Communicate: During sex, go slowly and ask permission to touch, kiss, stroke, enter, etc. Not only can this limit surprises and worry, but it can be wildly sexy.
• Talk it out: Speak with your friends (after you've had sex) if you're nervous about something that happened during sex. You'd be amazed at how many people — gay and straight — want to talk about the same issues. Perhaps your friends can share resources or trusty information.
• Reach out: Call an AIDS or STI hotline, or search online to get the facts that can reduce sex-related stress. For example, you can check out the GMHC Website
• Think about getting tested: There's nothing like a "negative" test result to relieve anxiety about a sexual encounter(s). "Positive" results can be met with many treatments that are helping people with HIV to stay as healthy as possible. Promising new drugs and longer periods without AIDS-related symptoms, however, does not mean to throw all caution out the door when in the throes of passion.

If you're having safer sex, but still have worries, speaking with a counselor may be helpful. There are many groups nationwide where HIV-negative people can talk about all of these issues, including how to stay "negative."