Aa
Evaluate our risk pls
Hello Doctor,
I'm a gay men in a long-term relationship, but both of us occasionally had sex with others (1-2 per year averagely). We consistently have unprotected anal sex and we really trust each other. We're open to each other. After last HIV test we both had, there are now two risky activities which make me kinda worried about.
1. One guy dipped my boyfriend for like 10-30 seconds. That's the only risky thing. That guy's status is unknown. After this, my bf didn't check up and kept having sex with me.
2. I received unprotected anal sex with one guy. This guy was tested negative one month before the encounter. He was very patient to answer my questions after the encounter, and send his status and test date to me via mail. I guess he's honest, but he is really active in sex, and he is kinda into unprotected insertive anal sex. (He admitted he did this before, but only as insertive role.) Moreover, he didn't fully insert the dick into my anus, and it was just like one or two inch. The total period would be about 2 mins. It happened about three weeks ago.
3. We both did oral sex and other body contact with other guys during the relationship, very occasionally though.
Like I said, we only occasionally performed sex with others. However, after the 2nd risky behavior, I began to think about the risk of HIV, 'cause we didn't take it very serious before. Both of us will do the tests soon, but can you please evaluate our risks before that? We both committed not to have sex, or at least not to have anal sex (as a bottom line), with others in the future, and we hope we can have a worry- and disease-free relationship in the future.
Thanks very much.
I'm a gay men in a long-term relationship, but both of us occasionally had sex with others (1-2 per year averagely). We consistently have unprotected anal sex and we really trust each other. We're open to each other. After last HIV test we both had, there are now two risky activities which make me kinda worried about.
1. One guy dipped my boyfriend for like 10-30 seconds. That's the only risky thing. That guy's status is unknown. After this, my bf didn't check up and kept having sex with me.
2. I received unprotected anal sex with one guy. This guy was tested negative one month before the encounter. He was very patient to answer my questions after the encounter, and send his status and test date to me via mail. I guess he's honest, but he is really active in sex, and he is kinda into unprotected insertive anal sex. (He admitted he did this before, but only as insertive role.) Moreover, he didn't fully insert the dick into my anus, and it was just like one or two inch. The total period would be about 2 mins. It happened about three weeks ago.
3. We both did oral sex and other body contact with other guys during the relationship, very occasionally though.
Like I said, we only occasionally performed sex with others. However, after the 2nd risky behavior, I began to think about the risk of HIV, 'cause we didn't take it very serious before. Both of us will do the tests soon, but can you please evaluate our risks before that? We both committed not to have sex, or at least not to have anal sex (as a bottom line), with others in the future, and we hope we can have a worry- and disease-free relationship in the future.
Thanks very much.
Thanks. I feel warm to get your help. You really read and THINK everyone's concern and provide professional advices.
I mean, some doctors just insist 3-month or even 6-month time mark, which is safe for them but keeps bringing people anxiety. Your style, especially the risk evaluation method, just eases our anxieties.
I will do 1 or 2 tests in the following weeks to finally stop my worries, and do whatever (routine checking, no unprotected sex, etc.) you suggest.
I mean, some doctors just insist 3-month or even 6-month time mark, which is safe for them but keeps bringing people anxiety. Your style, especially the risk evaluation method, just eases our anxieties.
I will do 1 or 2 tests in the following weeks to finally stop my worries, and do whatever (routine checking, no unprotected sex, etc.) you suggest.
MEDICAL PROFESSIONAL
It's good to hear that most of your anal sex events with others were condom protected.
There are no data on the risk of HIV transmission risk with brief versus prolonged sex. It is logical to assume the risk is lower with brief duration, but it is impossible to judge how much safer it might be.
A standard HIV antibody test will pick up about 90% of new infections at 4 weeks, so a negative result at that time will be highly reassuring; but a second test is necessary 6-8 weeks to be completely certain. If you are in a country where the combo test is available -- i.e. a test for both HIV antibody and p24 antigen -- then a negative result at 4 weeks is virtually 100% reliable. (The combo test was recently approved for use in the US; it will be available soon, but many clinics don't yet have it.)
There are no data on the risk of HIV transmission risk with brief versus prolonged sex. It is logical to assume the risk is lower with brief duration, but it is impossible to judge how much safer it might be.
A standard HIV antibody test will pick up about 90% of new infections at 4 weeks, so a negative result at that time will be highly reassuring; but a second test is necessary 6-8 weeks to be completely certain. If you are in a country where the combo test is available -- i.e. a test for both HIV antibody and p24 antigen -- then a negative result at 4 weeks is virtually 100% reliable. (The combo test was recently approved for use in the US; it will be available soon, but many clinics don't yet have it.)
MEDICAL PROFESSIONAL
I agree the negative test is highly reassuring, even at 3 weeks -- especially since both of you had negative results.
My final comment responds to "I haven't received test for years". If another test at 6-8 weeks remains negative (as almost certainly it will), and you and your partner remain mutually monogamous -- i.e. no sex at all with other men -- then you need not test again. If either of you continues to have other partners from time to time (even if oral only or anal with condom) then I recommend that both of you have a routine HIV test once a year, even if there are no obvious lapses in sexual safety.
That should end this thread. Take care and stay safe.
My final comment responds to "I haven't received test for years". If another test at 6-8 weeks remains negative (as almost certainly it will), and you and your partner remain mutually monogamous -- i.e. no sex at all with other men -- then you need not test again. If either of you continues to have other partners from time to time (even if oral only or anal with condom) then I recommend that both of you have a routine HIV test once a year, even if there are no obvious lapses in sexual safety.
That should end this thread. Take care and stay safe.
Just got oraquick result @ 3 weeks, negative
A good sign for me, and I also think my bf is neg, too.
I haven't received test for years. Although I have not done any risky stuffs except the one I mentioned, this result can at least let me know I'm all right for the past experience. Even for the most recent one, it is very encouraging for me. I'll continue to expect neg results in the future.
Thanks for your help, which offers me the courage to get the test.
A good sign for me, and I also think my bf is neg, too.
I haven't received test for years. Although I have not done any risky stuffs except the one I mentioned, this result can at least let me know I'm all right for the past experience. Even for the most recent one, it is very encouraging for me. I'll continue to expect neg results in the future.
Thanks for your help, which offers me the courage to get the test.
a small update
---- The brief anal sex my bf had was protected (90% for sure)
Because I'm so paranoid a guy, I should have had him tested if I knew it was unprotected. As I didn't let my bf tested at that time and both of us remembered it was highly possible it was protected, I feel relieved for him.
Without your comments, we wouldn't check this again. Thanks very much.
---- The brief anal sex my bf had was protected (90% for sure)
Because I'm so paranoid a guy, I should have had him tested if I knew it was unprotected. As I didn't let my bf tested at that time and both of us remembered it was highly possible it was protected, I feel relieved for him.
Without your comments, we wouldn't check this again. Thanks very much.
Thanks. I'll do the oraquick test at one month, and then 6 or 8 weeks. I will expect the good news for both of us.
Thanks again.
Thanks again.
I may mislead you to some extent. We seldom had anal sex with others. Even we had, the most cases were safe(r) sex with condoms. The only risky behaviors after our last test are the two listed in my post.
Thanks a lot. Yes, I believe it's great to truly exclude others to our relationship. We both played fire once as described, so we'll stop it. We won't have sex before our tests, and we won't play fire in the future.
I'm happy to hear that you expect the negative results for both of us.
Do you think the 20-second anal sex my bf had is that risky? We both thought it was very brief.
For my case, as the possible exposure to the guy is 3 weeks ago, how do you think about the accuracy of the test at one-month mark?
Thanks.
I'm happy to hear that you expect the negative results for both of us.
Do you think the 20-second anal sex my bf had is that risky? We both thought it was very brief.
For my case, as the possible exposure to the guy is 3 weeks ago, how do you think about the accuracy of the test at one-month mark?
Thanks.
MEDICAL PROFESSIONAL
Welcome to the HIV forum. I'll try to help.
First, the oral exposures with other partners really are not of concern. HIV is very rarely transmitted by oral sex. I would still recommend avoiding known infected partners and those of unknown status, but the likelihood of infection is low even if you don't follow that advice.
The unprotected anal sex events you describe are a different story. The greatest concern here is your boyfriend's unprotected receptive anal sex encounter (bottom) with a top partner of unknown status. That is the highest risk for HIV acquisition of all sexual behaviors. Of course it depends a bit on context: for example, a close friend who you believe is safe most of the time is one thing; an anonymous partner in a bath house or park is something else. But either way, in my view there simply is no excuse for men to ever have anal sex (even with condoms) with men who are positive or whose HIV status is unknown. This was a dangerous exposure.
Your own anal sex exposure was not quite as risky, since you exchanged HIV status information and most people don't lie when asked directly. Therefore, your partner probably didn't have HIV; and the risk probably is reduced given the brevity of anal penetration. However, since he is quite sexually active, there is at least some chance that he is in the window period, i.e. has acquired HIV since his last test -- and the window period is the time of by far the greatest likelihood of HIV transmission. One estimate is that half of all HIV transmissions occur in the 1-2 months after the transmitting partner became infected.
In summary, you and your boyfriend have been playing with fire. As you suggest yourself, it is time to start taking safe sex seriously. Your mutual promise to stop having anal sex with others is a great move and I'm happy to hear it. It's also a good idea for you and your bf to avoid unprotected anal sex (and maybe even condom-protected anal) until you have both been tested. But understand this: If you continue the behaviors described, you can expect to catch HIV someday. If that sort of thing is going to continue, or if you're not sure you can trust your boyfriend's intent (and your own) to not have anal sex with other men, then I recommend you and your bf commit to no anal sex, or at least to consistent condom use.
My intent is not to frighten you, just to make sure you understand the risks. My concern is for the long run, not necessarily for the particular exposures you have described. The odds are strong you aren't (yet) infected, and you can expect negative test results. You might go together to a public health clinic or other HIV testing center, then follow their advice about which test(s) to have and their timing. In addition, you both should have routine STD tests (gonorrhea, chlamydia, syphilis); and hepatitis A and B vaccines, if you haven't had them.
Let me know your test results when you get them. Good luck-- HHH, MD
First, the oral exposures with other partners really are not of concern. HIV is very rarely transmitted by oral sex. I would still recommend avoiding known infected partners and those of unknown status, but the likelihood of infection is low even if you don't follow that advice.
The unprotected anal sex events you describe are a different story. The greatest concern here is your boyfriend's unprotected receptive anal sex encounter (bottom) with a top partner of unknown status. That is the highest risk for HIV acquisition of all sexual behaviors. Of course it depends a bit on context: for example, a close friend who you believe is safe most of the time is one thing; an anonymous partner in a bath house or park is something else. But either way, in my view there simply is no excuse for men to ever have anal sex (even with condoms) with men who are positive or whose HIV status is unknown. This was a dangerous exposure.
Your own anal sex exposure was not quite as risky, since you exchanged HIV status information and most people don't lie when asked directly. Therefore, your partner probably didn't have HIV; and the risk probably is reduced given the brevity of anal penetration. However, since he is quite sexually active, there is at least some chance that he is in the window period, i.e. has acquired HIV since his last test -- and the window period is the time of by far the greatest likelihood of HIV transmission. One estimate is that half of all HIV transmissions occur in the 1-2 months after the transmitting partner became infected.
In summary, you and your boyfriend have been playing with fire. As you suggest yourself, it is time to start taking safe sex seriously. Your mutual promise to stop having anal sex with others is a great move and I'm happy to hear it. It's also a good idea for you and your bf to avoid unprotected anal sex (and maybe even condom-protected anal) until you have both been tested. But understand this: If you continue the behaviors described, you can expect to catch HIV someday. If that sort of thing is going to continue, or if you're not sure you can trust your boyfriend's intent (and your own) to not have anal sex with other men, then I recommend you and your bf commit to no anal sex, or at least to consistent condom use.
My intent is not to frighten you, just to make sure you understand the risks. My concern is for the long run, not necessarily for the particular exposures you have described. The odds are strong you aren't (yet) infected, and you can expect negative test results. You might go together to a public health clinic or other HIV testing center, then follow their advice about which test(s) to have and their timing. In addition, you both should have routine STD tests (gonorrhea, chlamydia, syphilis); and hepatitis A and B vaccines, if you haven't had them.
Let me know your test results when you get them. Good luck-- HHH, MD
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