Brief Unprotected Anal Sex — Top

I'm a 30-something bisexual male who engaged in anal sex recently with another male partner. I wore a condom for the majority of the encounter, but my partner pulled the condom off toward the end when I pulled out briefly then reinserted my penis into his anus. After a few seconds, realizing what had happened in the thick of the moment, I quickly pulled out and then ejaculated outside of him.

My partner is supposedly negative. But that he had removed the condom has me concerned. What are my risks of exposure to HIV in that brief few seconds?

[H. Hunter Handsfield, M.D.]

Welcome. Thanks for re-posting your question in this forum instead of the Living with HIV forum.

In general, people usually don't lie about HIV status when asked directly, so your partner probably isn't infected.  If he was, then transmission probably is less likely with brief exposures than with prolonged unprotected sex.  And the risk of HIV transmisison for the top paartner in anal sex, when the bottom partner is infected, averages once in 500 exposures. Considering all those factors, your risk undoubtedly is a lot lower than that.

Having said that, this was still a relatively high risk exposure, and I would recommend HIV testing in a few weeks.  Even better, speak with your partner and ask him to have another HIV test.  If a new test is positive, then you should seek post-exposure prophylaxis (PEP) with anti-HIV drugs.  If his test remains negative, as it probably will be, it would indicate you were at little or no risk.  But even then, you should also have an HIV test yourself in a few weeks, against the slim possibility that your partner is in the window period before the blood test becomes positive.

If I may make another point that has been said before but bears repeating:  This is an excellent example why safe sex among MSM includes asking about HIV status before starting any sexual contact, even when safe sex is planned.  Safe sex sometimes fails in the heat of the moment, as it did this time.

All things considered, your risk for HIV is quite low, but not zero.  Feel free to return to let me know your partner's and/or your own test results.

Best wishes--  HHH, MD

[theant90]

hello, try not to panic as you probably didnt contract anything.however you did have an exposure and unprotected sex however brief between gay males is deemed to be a higher risk group. if i were you i would take a duo test at 4 weeks and a final test at 12 weeks to be fully sure of a negative status.when was your exposure ?

[myotherside1]

My encounter was over this past weekend.

[myotherside1]

Thanks for the response. My partner was someone I just met and not someone that I regularly see. I myself don't engage in sex often and when I do I play it safe. This is perhaps only the second partner I've had within this past year.

In any case, even with the low risk, I will get tested in four weeks.

[theant90]

ive been in the same exposure position and thankfully my results came back ok, try to remain calm and keep busy and book those tests.and dont forget to get tested for all other stis as they are much easier to transmit than hiv

[myotherside1]

Thanks for the reassuring words. I will.

[theant90]

you are welcome and i truely believe that you will be ok