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Your Top 10 Sex Etiquette Questions in the Age of AIDS

Manners experts rarely visit the bedroom, much less the back room -- at least in print. When they do, it's a disaster. For instance, Letitia Baldrige posits in New Manners for New Times that having "multiple sex partners is the worst of all worlds." Sorry, Tish, but can you spell j-u-d-g-m-e-n-t-a-l? Other advice is noteworthy for its faux sense of security, or for its lack of the "real-world" factor: Who would actually bring copies of their HIV test results to exchange before getting down to business? (It's true that "people may lie" about their status, but... really? And remember, even printed results are only as good as the paper they're printed on and don't reflect what your soon-to-be partner has been up to lately.)

As the XIX International AIDS Conference winds down, it's never been clearer how crucial it is that we remain honest, patient, and respectful of each other -- whether in the bedroom or in any other room you like. Here are your top 10 queries on HIV/AIDS manners:

Question: When do I talk about HIV with a new partner?

Answer: Before your clothes come off or anything gets unzipped. You owe it to yourself and any prospect to talk about your sexual health before having sex (and I mean that in the broadest sense of the word). Be truthful and direct, saying, for instance, "I just want you to know that as far as I know, I'm HIV negative. When were you last tested?" or "I'm poz. Let's make sure we're on the same page about what we mean by safer sex." The bottom line: If you feel intimate enough to have sex with someone, then you're close enough to talk about HIV status.

Question: How do I ask a new boyfriend to get tested?

Answer: Suggest doing it together. No matter your age or experience, sexually active men with multiple sex partners should be screened at least every three months for HIV/AIDS and other STDs, says Dr. Frank Spinelli, a gay men's physician in New York City. Don't consider foregoing safer sex at least until a repeat test three months later (and an agreement to be monogamous and use condoms in the interim).

Question: Is it wrong for HIV-negative guys to "seek same"?

Answer: No. Many guys, whether positive or negative, are into sero-sorting these days -- that is, only hooking up with those of (presumably) the same HIV status. Note that I said "presumably," because being "disease-free" is meaningful only in the moment you're being tested. Candid, up-front personals, such as those on Craigslist or various apps, can help smooth the way for more satisfying sexual (and emotional) relationships. But don't fall prey to this phrase "u be clean and disease-free 2" -- unless you're really into good hygiene. If you're going to take a pass on someone, I say it's better to do so in the virtual world than after you've met in real life, but be considerate no matter the circumstance.

Question: Is it rude to spit rather than swallow?

Answer: Let's talk public health before manners in this case. Says Richard Cordova, Safe Sex & HIV Prevention Expert at TheBody.com, "I like to say, 'Swallow or spit, don't let it sit.'" The risk, he adds, comes from having someone's semen in your mouth. So no, it's not rude to spit if you prefer not to swallow, but whichever option you choose, for once in my life I'll suggest following advice from the Boy Scouts: "Be prepared."

Question: What do I do about a guy who won't wear a condom, especially when I'm really turned on?

Answer: That's easy: Don't have sex with him. If there's any tool we have to prevent the continued spread of the virus, it's the much-maligned, low-tech (but lifesaving) condom. That's a lot easier when you're sober: The potent cocktail of alcohol, drugs, desire, and casual sex is closely tied to new HIV infections, which still total more than 40,000 each year here in the U.S.

Question: I performed oral sex on someone who then told me he was HIV-positive. Shouldn't he have told me ahead of time? Was I at risk?

Answer: It takes two to tango, my friend. Not to do any finger wagging, but if he didn't tell, it was your right (your responsibility, in fact) to ask. Never assume someone is HIV-negative, especially on a first encounter. Instead, presume they're HIV-positive and act accordingly. That being said, many states now require individuals who are HIV-positive to disclose their status to all new partners beforehand. As for your risk:
"Oral sex is considered lower risk than intercourse, but there are documented cases of HIV transmission through oral sex, especially if ejaculation is involved. As a general rule, avoid performing oral sex if you have an active oral herpes infection," says Dr. Spinelli.

Question: The condom broke yesterday while I was having sex. What do I do?

Answer: First of all, don't panic -- and don't play the blame game. Talk with your partner (if you haven't already) about his HIV status and sexual history. If he's positive or hasn't been tested in a while, go to an ER, explain the situation, and ask for what's called PEP, or post-exposure prophylaxis (a 28-day course of an antiviral medication). Even if he says he's negative, talk through the options with a trained medical professional. Says TheBody.com's Cordova, "The reality is that is there are many factors that determine whether an infection is likely to occur. Viral load and whether or not you were the top or bottom are the two biggest." Regardless, if treatment is prescribed, begin medication ASAP, because you only have a 72-hour window to reduce the likelihood of infection.

Question: I had unprotected sex with someone, and I'm too embarrassed to tell him that I have an STD. Can I just text him with the news?

Answer: One way or another, you must get this information to him, and I'll tell you I would not want to see this message pop up on my phone. So make the effort to get over your red-faced self and talk with him. Still, if your embarrassment is too great, then go ahead and text, but ask him to let you know that he received your news; you wouldn't want this information to wind up on someone else's not-so-smart phone.

Question: My friend's partner is ill. I'm worried that it's HIV. Is it OK for me to ask?

Answer: Sorry -- good intention, wrong question. In fact, it's really not a good idea to ask about anyone's medical diagnosis (think privacy). Unless someone has a contagious disease, such as TB or the flu, there's no legit reason for you to know... until he's ready to tell you. Instead, ask your friend if you can help with some food shopping or other chores to lighten his load. Question: I recently told my parents that I tested positive, and now they've gone and told my extended family without my permission. What do you think about that? Answer: A good rule of thumb when disclosing your HIV status in the future is to be clear about whether it's private or OK to share. For those on the receiving end of such info, don't be shy: Ask whether you can talk about it (or not) with friends or family, and don't stray. (Note: This is true for any medical condition, not just HIV/AIDS)

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