HIV from Kissing... Impossible?
 

Hi, recently I started dating someone... but I'm not gonna get into the emotional details of this story. This has really affected me emotionally and I'm coping with it the best I can, but it is such a difficult situation and I just want to stick with the purpose of this thread.
Anyways, we dated a few times and we kissed a few times. Nothing rough, just nice and slow french kissing, very passionate. After 3 weeks, just when I was really liking this guy (we saw each other every day and chemistry was incredible) he confeses me he's HIV+. First I was really confused, I didn't really knew that much about the virus, then I was really really sad, I had though of this guy as "the" guy.
Then, I was scared as hell. I remembered I had bit myself while eating and like two hours later (maybe less?) I was kissing him. He doesn't have sores or cuts in his mouth, but still I really don't know the risk of me getting it from kissing him couple of hours after biting myself while eating.
I'm just scared to death from getting HIV and it just wouldn't be fair because I've always taken so much care of myself and now I get it from kissing a guy a really really liked. I guess I have not luck whatsoever.

I hate being the bearer of bad news, but what happened would put you into a high risk category. You didn't say when this happened, and that's really important.

If it was within the past 48 hours, you would be a prime candidate for post exposure prophyllaxis, which usually consists of 2 anti HIV drugs taken for 30 days. Past 48 hours, antiviral treatment probably won't abort an infection.

Saliva does confer some protection against the virus, and routine kissing is not considered high risk. In your case, infectious fluids did get exchanged, and you did have an open wound which would allow entry, so all bets are off.

The LIKELYHOOD of your getting infected from this encounter is slim. But it is very possible, and you need to speak to a doctor or clinic that deals with HIV ASAP. This is not a "we can see you in 3 weeks" situation. I know it's scary as shit, but please, don't waste time.

Dr Danny

What do you mean "infectious fluids did get exchanged?" He DIDN'T have open wounds or sores in his mouth. Aren't blood and semen the carriers of this virus?

1. Saliva contains HIV virus. Tongues touched. His tongue had his saliva with his virus (we don't know how much) in your mouth. Hence "infectious fluid" It isn't limited to blood or semen.

2. You bit your mouth. You interrupted a protective barrier. On a size scale, think of the virus particle as a Boston Marathon runner. All of them running down the New England Throughway.

Now PLEASE, don't argue, see your doctor pronto! I may have the time frame off regarding the bite and the kissing, and that is why you need to talk, face to face, with a physician.

Dr Danny

Chevo:

Listen to the doc!

To clarify a bit -- saliva is not considered "as infectious" as other body fluids. Perhaps this is the basis of your confusion here.

It is difficult to quantify your personal risk in this real-life situation. There are lots of variables.

Do be aware that oral cuts tend to heal rapidly in healthy individuals. Even if the cut you had in your mouth was not fully healed in a matter of a few hours, most likely the bleeding had stopped and healing had at least BEGUN. This is good news. But it's also speculation, so bear that in mind.

To Doctor Danny: I thought HIV prophylaxis treatment was only available to health care workers at this time. In fact, I was fairly sure I read something recently which mentioned that "they" are trying to get approval (from who?) to release HIV meds to the general population in situations such as this where prevention is at least still possible. Is this information incorrect? Can "regular folks" get HIV prophylaxis? If so -- that's great! I'm glad to be incorrect.

Chevo, there ARE reported cases (very few) of HIV being transmitted from kissing. In most instances, both individuals had some severe gingivitis going on with lots of oral lesions and bleeding. These are cases CONFIRMED by the CDC. This means we only know that these have been documented as true. The number of cases of HIV transmitted from kissing is not absolute. There may be many more incidents that are not confirmed or even remotely provable within real-world sexual contact.

"Impossible" is not a good word to use when discussing medical issues. SOME things are certainly medically impossible -- women don't get pregnant from holding hands with a man -- but placing a clear-cut label of "yes" or "no" on something as complicated as HIV can be a mistake.

No one here is trying to frighten you. I would like very much to tell you that I feel HIGHLY CONFIDENT that you will be fine. But you need to take immediate action just the same. You may be in for a few rotten days ahead, but when they are over I hope to have you come back here and let us know that everything worked out for you.

It would also be a good idea to get tested again in three months or six months or both. Meanwhile, if prophylaxis is available to you and you meet the time-frame criterion -- get it done!

Finally... it's evident that you are also emotionally and spiritually stressed by this turn of events in your relationship. A partner who begins and relationship with a lie of omission is not a suitable partner, in my opinion. I'm sorry you have to deal with this, but overall I think it's much better that at least you know NOW before any future sexual encounters led to anything even MORE high-risk.

Should you wish to discuss the other aspects of your situation, the mental and emotional stresses involved, start a new thread and I'm sure lots of us guys would be glad to help you out.

Let us know how you are doing and what you find out, please. I don't want to be left hanging on this one, OK?

If I stated anything here that is medically inaccurate, Dr. Danny will make the necessary corrections -- listen to HIM first.

Take care.

I have an appointment on monday, I'm going to get a consult appt. and get tested also. I may ask for a DNA PCR testif it is available and affordable (to me at this time), this test is 95% accurate 28 days later after exposure (25 have already passed :( ). I'm scared as hell.

I DID speak to his nurse the day of exposure, just right after he told me he was HIV+ because I 'freaked out.' She said that unless he had bleeding gums and/or bleeding cuts than I shouldn't worry about it. He didn't, so we assumed I "didn't have anything to worry about", but still I had my doubts, that is why I posted this thread. I read there is just one 1997 report of a woman getting the virus by kissing from her husband, I haven't heard of any others. Still, it is hard to be optimistic about this and I'm already thinking I have it.

Dr. Danny: Thank you so much for your time and I really wasn't trying to argue like that. I AM listening to what you're telling me and I do understand that even though it is very unlikely, it IS theoretically possible. I'm late for prophyllaxis and the doctors at the clinic mustn't think it is necessary because because I did explain my situation and they just gave me an appointment for next monday. Trying to think possitive here... I haven't had any symptons... and I'm praying I end up in the 'unlikely' side of the situation. I'm going to try to see a physician also like you said and try to see if a can get a more accurate test than ELISA (time-wise). I just can't keep up with this anxiety for 6 months, it's not like it's my only problem.

So again, thank you for your help, and I'll keep in touch Scruffycub! ;)

It would be way beyond the ethical pale to offer post exposure prophyllaxis only to physicans/health care workers. It's just we have almost instant access to care/meds.

It boils down to a time frame. If someone walked into my office, admitted to unprotected, receptive anal sex the night before, complete with ejaculation, I would say a few Hail Maries, cross my fingers, and write the prescriptions. If the same guy (gal) came into my office with the same story except the exposure was 3 or 4 days ago, I wouldn't.

We don't really know that post exposure prophyllaxis really works, what the best recipe is, etc. It looks like 48 hours is the upper limit of success. And frequently, triple drugs after a deep needle stick fails

Chevo, your posting went on as I was typing. For what it's worth, the acute flu like illness associated with HIV infection usually starts 7-14 days after exposure. You haven't described symptoms, saliva is not overly infection, so in all likelyhood, you are going to be fine. A few grey hairs, perhaps, but fine. You are in for a few really rocky days, and a roller coaster of emotion. I know, been there myself. But go throught the testing, and you will sleep a lot better when it's over.

My final bit of philosophy/theology:
There are no atheists in the foxholes.

Good luck, please, keep us/me posted

Dr Danny

Guys.....we are so fortunate to have someone like Dr. Danny looking out for us on this bulleten board!

Drifting OT
 

That oft quoted "no atheists in foxholes" is just clearly wrong, and very patronising.
Just one example of many: The thousands of weary fighters who endured the most atrocious conditions and held Stalingrad.

Then consider yourself patronized

Doc: hey, what's more to say than "thanks again?" I'm not sure how or why or where I read that tidbit about prophylaxis for health-care professionals. Glad to hear it is not true. Maybe -- but don't quote me -- I'm thinking of some sort of loophole legislation that is trying to get passed that would make it faster and easier to get these meds. I recall some sort of debate regarding the efficacy of this. Yet it addressed the problem the doc mentioned -- the timeline for prophylactic treatment. If this is the case, of course I'd love to see meds available immediately after unprotected sex.

Chevo: I'm quite confident you'll be fine -- but I like to make sure dudes FOLLOW THROUGH. Sometimes a little worrying is necessary to make sure that happens -- but you did all the right things on your own.

One comment about sero-conversion sickness (the flu-like illness sometimes reported after HIV infection): the keyword here is "sometimes." This illness does NOT always happen. Quite often guys come flying into online message boards or chat rooms worrying that they caught a cold after sex and believe it to be HIV infection. Almost always... it's just a cold. The presence of cold or flu-like symptoms does not indicate HIV -- nor does the absence of them indicate that there was no infection.

That's just for the record -- I'm aware it isn't all that pertinent to this post.

Scruffy has just hit on one of the more fascinating aspects of this horror, the "flu like illness"

True, it doesn't always happen, BUT...

The majority of guys (so I'm a sexist, eat me), who are infected do get sick initially. High fever, tender, swollen lymph glands, fatgue and more than 50% with a flat, very red, non raised, spotty rash. It's more like mono than a cold. If it happened to me a week or two after I had been messing around, I would freak out, and heavens (ahem, atheists in foxholes, pardon em moi) knows, I've got a bit of knowledge between these ears. And this "cold" lasts up to 2 weeks!

Gentlemen, we are facing the worst crisis since 1981, and once again we, and the media, are burying our collective heads in the sand. Please protect yourself, because the other guy isn't going to . And God forbid you get sick, it isn't Bush's fault. It's yours!

Bleeding Gums
 

If an HIV positive person brushes and flosses his teeth and there is some residual gum bleeding afterwards, the presence of HIV in saliva can be assumed and does pose a risk to someone with an open wound in or near the mouth cavity.

Rather than minimize the exposure risk ... get tested!

We probably should put in a plug for maintaining good dental hygiene (brush, floss, and use a good mouthwash/antiseptic) since kissing is obviously not a risk-free practice.

RE: The "flu-like" Symptoms. Last fall, we began the flu season with a shortage of flu vaccine. Who do you think got the flu vaccine? Given the shortage of the flu vaccine, there is a high probability a person might have had "flu-like" symptoms and would never be any more wiser -- it could be something else. This is something that can't be taken for granted.

Let me start by saying this answer is in no way an endorsement for unsafe sexual practices. It is just one person's experience. I am on meds and the virus is undetectable in my blood. The theory (unproven of course) is that I am, therefore less likly to be infectious.

Chevo, go to thebody.com and on the left, click on safe sex. There you will probable find a question just like yours and an answer. If not, then submitt your question to the experts. The one thing you will notice over and over again is the number of guys who are convinced they caught HIV, but didn't (and there are some really silly questions, like getting a lap dance with clothing on)

HIV is not an easy disease to catch. Many things have to go wrong at just the right time. In my case, I had unprotected sex with my wife for nearly 3 months after infection BUT before diagnosis. She tested then, 30 days, 60 days and six months... she is not infected. I had receptive anal with a buddy once during that time.....he's not infected. The fact that you bit your mouth should be of some concern, but it's not an automatic infection. It is all still theory, but the thought is that you need a huge (or several) exposure to get infected, which didn't occur in your case. My wife and I still deep kiss. We both know there is some risk, but it is minimal and acceptable to us. Same for cunnilingus, though I discourage her from fellatio and would never come in her mouth.

As for the PCR test, yeah, very expensive. Just a normal VL test for me runs over $450. PCR is even more....it is DNA testing, afterall.

BTW, my wife e-mails a friend in Canada who also has a poz husband (ain't the internet wonderful?). They had a condom malfunction about 40 days ago. She went on PEP and the good news at her 30 day test is she too is neg. The current window for starting PEP is 48-72 hours.

Hey everyone! Tomorrow is my test, so nervious, I'll recieve the results on wednesday. Thanks to everyone here... been great help!

I visited body.com and according to them:

1. There isn't a CDC documented case about infection through kissing. I'll be making history here! The 1997 case ended up being classified as inconclusive.

2. My case is considered a low-risk situation... I wouldn't apply for a PCR test unless I want to pay tons of cash.

3. Saliva is NOT considered infectious fluid as of now, with or w/out a cut/sore from the uninfected person. Saliva has some protein that kills the virus and it's acid level also help. Also, in the patients that they found the virus in saliva, it was in very low concentrations (not enough for infection).

Theoretically I guess it is still possible, that is the only reason I might be nervous, but winning the lottery is also possible. Some facts that also help my anxiety level to lower a bit are:

1. The infected person's viral load is "undetectable" right now. AKA <400 count. This lowers the risk of infection even more.

2. He wasn't bleeding through sores or cuts and we didn't kiss anytime directly after brushing our teeth. Plus, the mouth is one of the body's parts that acts more rapidly towards wounds' curation.

3. I don't believe in bad luck (just the lack of it ;) )

Chevo,

That is all great news and good luck (though I don't think you need it).

BTW, there are two HIV viral load tests routinly ordered. The one my doc orders (HIV-1 RNA by PCR) is sensative down to 50 copies per mL and as I said, I am undetectable. One last bit of info. There can be unexplained "blips" in a persons vl. Thought to be caused by another viral infecton (cold, flu, etc) or an innoculation. But they are only noticed if the test is run during the blip. So it is still important to play safe.

Personal Ethic in Relationships
 

I can't help but think of the high state of anxiety Chevo must have went through after he learned the guy he was dating was HIV positive. Never mind the fact they had only kissed and nothing more progressed beyond that. But still, he and this other guy had a few dates before the other guy decided to tell him he was HIV positive.

We'll never know why the other guy withheld the information in the beginning, when they first dated. That's the kind of information that just doesn't slip a person's mind when you date someone the first time even if you don't have sexual activity together. You have to figure, after all, that passionate kissing on the first date could have led to sex itself. The fact they didn't have sex on the first date would be beside the point because the other guy withheld vital information about himself that had the potential to seriously impact the life of another person. I guess that is what really bothers me. It is also the reason why I always use protection and play safe.

It may seem unfair to the other guy who is HIV positive, but he did have an ethical obligation to inform Chevo of his HIV positive status in the beginning. Waiting until after they had dated a few times before he informed Chevo raises the issue of personal ethic in relationships. We don't often discuss this aspect of relationships and, when we do, it is usually after the fact and after something has gone wrong. In this particular case, the potential for something going wrong was certainly there.

The amount of anxiety Chevo has experienced is the price he must pay. This time he was lucky. But, the next time .... ??????

Chevo:

Will be eagerly awaiting the good news I know you will be able to share with us tomorrow!

Many thanks for the info you reported from TheBody. I have NO freaking idea WHEN the CDC determined the reported case of HIV from kissing has now been deemed inconclusive. That's very interesting, thanks for sharing it.

Funny... I frequently recommend folks go visit www.thebody.com , yet I haven't browsed the site in a long time myself. I used to do message boards with the doc that founded it.

There is some disagreement with regard to the classification of saliva as infectious and non-infectious. I take it the CDC's official position is that it is not. Others may have a different point of view.

Thanks much for the update.

hey everyone! wow... I didn't expect so many replies to this!

About the ethical dilema of the HIV+ guy, I do think he should've told me. He DOES know it was wrong from his part and tried to explain he's point-of-view in this matter (even though I don't agree w/ it so much). We dated a few times, kissed a few times, hugged a few times and all but oral or anal sex never happened. To tell you the truth, this was what made me ask him, because he 'freaked out' everytime things got really hot.

I really like him and think he is such a beautiful person. Even though I get mad at what happened, I do understand him at some level and I don't ever want to be in his position. The thing is that, other than the anxiety part of the HIV situation, I was emotionally destroyed. I was really thinking about this guy as a potential lover, like a serious relationship. Actually, the first thing I did when he told me, wasn't freaking out... I started crying. It was like a slap on my face, telling me it was too good to be true. I do love this man, even though I've known him for one and a half month, but I feel it. It hurts to know that it will never happen, I'm just not prepared for this kind of relationship. On the other hand, I learned alot from this situation and instructed myself to this world that I knew nothing about.

The good news is, I just got the results from my test, it's negative(non-reactive)! The doctor says not to worry about coming in 3 months, I'm not considered as a high-risk contender, or even low risk, he said "extremely low actually." He said that just do the routin 6 month test in the summer and that he knows I'll be fine, that he "doubts I'll make history from this exposure."

Thanks everyone for your support and take care of yourselves! and you're all free to keep making comments and discussing!

A Clearer Perspective
 

Now that you have gotten over the emotional hurdle, you can now begin to see things much clearer and objectively.

What this other guy did, from an ethical perspective, was wrong. He withheld vital information about himself that potentially could have fucked up your life. There is no way around this ethical issue. The very first time you and he dated obligated him to tell you he was HIV positive. If he had done that, you would have been informed about his health status that could have significantly impacted your own health and life. Remember, it was his ethical obligation to inform you.

In relationships, whether it is a single date or several, we do have an ethical obligation to inform the other person about such things as our HIV status. In some states, it is a crime for a HIV positive person to not inform a sexual partner of their HIV positive status. The issue here is informed consent. Concealing one's HIV positive status denies others of their right to be informed. If we take care of our ethical obligations first, there will be little or no need to address the legal obligations.

We don't always talk about our ethical obligations to each other, but you can be certain somebody is going to point out our legal obligations.

BMG, I doubt we will ever agree on what I am about to say, but I don't think an HIV+ individual is obligated to inform someone on the first date AS LONG AS THEY DON'T PARTICIPATE IN UNSAFE PRACTICES. What about herpes? Past sexual partners? Other health issues? What if you tell someone on a first date, before you really get to know them, and they go blabbing it all over the community, the internet, the employer, the family?

Yes, there is an obligation to inform a person before the relationship gets too deep or sexual. But sure as hell not on the first date, legally or morally. As you said, some states require you to tell a SEXUAL PARTNER, not a casual date.

My 2 cents.

I agree sexual partners should be informed. But the rest of the world, no. Forcing a person to divulge info that is not necessary smacks of the same thinking that forced women to wear scarlet letters.

This is a tough social problem for gay men on the sexual playing field, but we are getting better at it I think. Obviously, the young man did not disclose his status to Chevo because of the social stigma attached to HIV and the fear that he'd lose Chevo's interest, which, ultimately happened. It sure wasn't that he forgot about it. Being a peer of Chevo's, early 20's etc., he hasn't had enough life experience to deal with something so volatile in a morally sound way that's comfortable for him and his future partners. This is an issue that needs attention in our outreach and education to young people, poz or neg.

I don't agree that guys who are not engaging in any kind of sexual activity need to disclose their status. However, there's nothing wrong with asking the guy you're on a date with what his status is. That's part of risk management, we can only be responsible for ourselves so asking right up front is a good place to start with that. We need to keep in mind however, that a negative result is only good fromthe time the blood was drawn until the next sexual encounter you have. This moral dilemma can get even more complicated as a negative guy could tell his sex partner his last test was neg, but fail to tell him that three nights later he had unprotected intercourse. So, also asking if your parnter practices safe sex all the time is another question to add to the list as part of risk management.

This situation takes work for everyone involved. Guys who are positive need to find a way that they can disclose their status comfortably without fear of social outcast, and negative guys need to develop respect and have discretion for guys who disclose their positive status to them.

I just want to say that I'm very pleased your test came back negative, Chevo. And I wanted to thank you for returning to keep us informed.

I'm not going to get into a detailed discussion about the ethical issues here, at least not right now.

I'm just glad things have worked out for you.

If a person is HIV positive and conceals their HIV status, the other person cannot have consented to any sexual activity in which they would have relied upon that information which was concealed. In other words, concealment of HIV positive status would deprive another person of vital knowledge a reasonable person would rely upon in consenting to have sex, regardless if they intended to have unsafe sex or not. As a matter of law, in some jurisdictions, criminal intent is demonstrated by the concealment of such information.

I suspect our disagreement on the ethical aspect of these relationships is the heavy burden placed on the HIV positive person. You're right Indy, we never will agree on the ethical obligation imposed upon HIV positive people. It's a heavy burden that many HIV positive people have just because they are HIV positive. As I pointed out in my last response, if we fail to address our ethical obligations to each other, you can be assured somebody is going to address our legal obligations.

As it now exists, there is great resistance to discussing what our ethical obligations are to each other. It is indeed unfortunate the heavy burden falls upon the shoulders of HIV positive people. While I do understand why an HIV positive person might want to conceal their HIV positive status, there is an overriding and compelling public health consideration that makes what appears to be a private matter a public health and safety issue.

I just happen to think the issue of personal ethic between ourselves obligates us to disclose vital information which would impact the publics health and safety. We need to bring peer pressure to bear upon ourselves in accepting the burden of responsibility, rather than have that responsibility imposed upon us in the form of punitive criminal laws. Some jurisdictions have already done exactly that. If we take care of the ethical questions of our behavior, there will be little or no need for criminal sanctions. That is all I am saying.

HIV status notification
 

This topic once again brings up the subject of when an individual should devulge his(or her) HIV positive status.
The law in many states does require that a POZ person inform their sexual partner before engaging in sexual activities. As a POZ individual, I personally have no problems complying with that requirement. As I see it, anyone who is positive and engages in reckless sexual behavior with another without informing their partner is indeed guilty of reckless endangerment.

But when should you inform someone?

When you first meet someone? One the first date? Before the first roll in the hay?

Let's look at the first senario. Let's set the scene; you're out at tyour favorite waterhole and a someone catches your eye. After the usual game of eye contact and wait and see, one of you finally approaches. After some small talk, you begin to feel some connection with this possible Mr. Right. OK, now comes the first decision, do you tell him now that you are HIV+ and risk immediate rejection? The responses that may come at this point run the gamut from him excusing himself to use the restroom(get another drink, ie) and not returning, or perhaps he'll overreact (drama queen alert), and blow up at you and acuse you trying to spread the virus to take as many as you can with you. Either way he may spread your news around the bar with in minutes.
Scene two. You have decided not to tell him until after you have gone out a few times, but before the 'deed is done'. Now this can be risky, as you may have invested some time and have developed feelings for this person and now face the possiblity of the drama queen response, or just having the person disappear like somene that owes you money. And again you risk having your status spread all over town

Finally scene three; You have dated for sometime, developed strong feelings for your prince charming, and decide to take the relationship to the next level. You tell you man and he reacts in one the two ways mentioned in senario two.

Or not, you also may meet some one in senario one, two or three tells you that he can deal with your status. Somewhere along the way (usually just before the first night of passion) that he really can't deal with the issue. See end of senario two.

Now there is always the slim possibility that dream man might actually me able to handle you HIV status. But trust me those men are just found in made for TV movies.

How do I know of all of these senarios? I have lived all of them. I did unscientific poll on AOL a few years ago and found that most guys will state that an HIV+ person should be able to date, but most would not date someone that they knew to POZ.

Of course there are the bug chasers and those that deniy the existance of the HIV virus. But those are guys you probably want to stay away from.

So for me, I've found it simply easier not to bother. This April it will be 4 years since I have enjoyed another man's company. This isn't to say that I don't enjoy the companioship of my friends, but I probably will never share my life with anyone in a physical way. You might say that I'm bitter, well not anymore. I was for a while, but I have since come to accept this as the way my life has to be. It just takes far too much of my energy to deal with the problems of others.

Chidog,

You don't have to answer this, but have you considered other poz guys as relationship or sexual partner material? Maybe I am being naïve, but I would think this would ameliorate a lot of the issues that prevent you from taking relationships a step further.

Yes, I know that even if you are both poz it doesn't mean you can forget taking precautions. I just feel your HIV status becomes a non-issue or actually would strengthen the bond between you.

I don't know when it is the "best" time to tell someone you are poz. I just know it isn't just as the two of you are undressing each other.

Catch 22
 

Chidog, it is a real dilema. What gets me is that guys are more than happy to play with a guy who doesn't know his own status, has NEVER gotten tested, than a guy like me, on meds, undetectable vl, always plays safe, and hence less risk than "Mr Don't Know". But I often quote Jimmy Carter to my kids, "life isn't always fair".

Ethical and Legal Obligation to Inform
 

Poz _ MBiM is right about the irony of some men having unprotected sex with men who don't know their HIV status -- meaning they have never been tested ... period.

The CDC has conservatively estimated there are 900,000 people in the United States who are HIV positive and they don't even know they are infected with the HIV.

One thing is for certain. Poz _ MBiM is not one of the 900,000 people who don't know they are HIV positive. The point I have consistently emphasized is the ethical burden of responsibility an HIV positive individual has to an individual who may become a sex partner where the possibility of having unprotected sex might occur under circumstances that are conducive to transmitting the HIV as well as other sexually transmitted diseases.

Having anonymous sex with strangers has certainly raised the stakes for everyone. Having anonymous unprotected sex with strangers raises the stakes even higher. Despite the appalling number of people who are HIV positive and don't even know it, having unprotected sex with people who don't know their HIV status continues to be an acceptable risk some people are willing to take.

Why some people are willing to accept the risk associated with having unprotected sex with anonymous people underscores why it is important to address the ethical issue of informed consent. As adults, I believe we have an ethical obligation to inform our potential sex partners if we are HIV positive. Withholding that information from our sex partners nullifies the underlying principle of informed consent and has the potential to expose an HIV positive person to criminal charges of reckless endangerment. In some legal jurisdictions, criminal intent of reckless endangerment is demonstrated by the deliberate withholding of HIV status and having unprotected sex with another person. As such, the burden of responsibility for informed consent goes well beyond the ethical responsibility we have towards each other.

If we address the ethical obligations towards each other, there needn't be an occasion where our obligation to inform becomes a legal obligation issue with potential punitive criminal sanctions.