Another means of building trust is to not make any assumptions about the type or amount of sex a person is having. Just because a person is married, for example, does not mean that he or she is monogamous or heterosexual. Effective trust-building results in a patient feeling comfortable talking about his or her risks around HIV regardless of sexual orientation or past sexual experience. Communicate The Risks Patients may have questions about the risk of being infected with HIV as a result of engaging in particular sexual activities. Answering this question helps the patient probe deeper into how they understand the risk of oral sex in the context of their own lives.
Oral sex is safer than unprotected vaginal or anal sex.
When counseling patients about safer sex, it is important to help patients make connections between their sexual risk-taking and other issues in their lives. A client concerned about his or her unsafe sex while under the influence of alcohol or other drugs, would need counseling about substance use as well as about safer sex. Other issues, including domestic violence, sex for drugs or money, and sexual assault are opportunities for counseling, support, and referral. Genital tract secretions may contain millions of particles of HIV, especially in individuals who are acutely infected, who have advanced disease, and who are not receiving antiretroviral therapy. HIV inhabits white blood cells, particularly CD4 lymphocytes, and monocyte-macrophages.