Unprotected vaginal and anal sex no ejaculation

[ilovethelord]

About 7 weeks ago I had unprotected anal sex with my boyfriend he pulled out before he ejaculated and last week I had unprotected vaginal with no ejaculation , he put on a condom before he ejaculated.  What are the risks assaciated with exposure to possible precum.  His status is unknown and I know his sexual history he has slept with lots of African American women which I have heard are in a higher risk group.  He says he mostly used protection except for in a couple of relationships he has been in.  Just 4 days ago, I noticed I wasn't feeling well, had 99.3 temp, sore throat that comes and goes and no appetite which lasted for about 2 days.  I also noticed swollen and tender gland on left side of neck.  Today I feel not so great, just that overall feeling of not being well, but back to normal temp which was 98.2.  My throat just hurts today and I feel lousy.  Am I being paranoid?

[Edward W Hook, MD]

Obviously this is not something that can be studied scientifically.  There is HIV in pre-ejaculatory fluid. Therefor there is a theoretical risk.  The amount of HIV present in pre-ejaculatory fluid is lower than with ejaculate, therefore the risk is lower.  How much lower is unknown.

As I said before, if you want to be safe and do not know your partner's infection status, use a condom.
EWH

[ilovethelord]

Thank you for your answers.  So is there or is ther not cases documented of HIV being transmitted through pre-cum.  It seems as if the CDC is saying yes.  Are they meaning as in like 1 out of a million cases?  Can you clarify they make everything seem so scary. Theoratical risk applies in a situation that they believe can happen?  

[Edward W Hook, MD]

Welcome back to the Forum.  My answer is that yes, you  probably are being paranoid as your risk is quite low.  I will try to put things into perspective and provide you with some information and some suggestions.

1,  Your risk.  The likelihood that any heterosexual man who is not an IV drug user has HIV is very, very low - somewhere in the neighborhood of less than 1 in 1,000, even if he has had African American women as sex partners.  Furthermore even IF your BF has HIV, your risk of getting infected from a single act of intercourse is again only 1 per 1000 exposures so, after two acts of intercourse, if he has HIV (unlikely) your risk of infection is less than 1 in 500.  

2.  Unprotected intercourse is unprotected intercourse.  The amount of HIV present in ejaculate is greater than in pre-ejaculatory fluid but it is still there.  Just as women regularly get other STDs and get pregnant following exposures to partners who do not ejaculate, they could get HIV.  You should use condoms.

3.  Your symptoms are non-specific.  Your symptoms have begun too soon relative to your most recent exposure and too late relative to your exposure 7 weeks ago to be typical of early HIV infection.  Typically HIV related symptoms of early infection occur 2-4 weeks following exposure.  It is far more likely that you just have an everyday viral sore throat.

So, what to do.  My advice is that the most direct approach is to get your BF to have an HIV test.  If he is negative, you can be confident that you were not exposed and do not need further testing.  If for some reason he cannot or will not get tested, they at 8 weeks a negative blood test will entirely rule out the possibility that you got HIV form the exposure you describe.

Hope these comments help.  EWH