Have I got HIV from unprotected insertive sex with a man?

[Worried Of Birmingham]

Hi,
I've been worried for some time now about a sexual encounter that I had a while ago in London.

Facts:
1. I am a 30 year old man and performed insertive anal sex on another man, who I think was hispanic.  I have no idea whether he was HIV positive.
2. The anal sex lasted for no more than 2-3 minutes.
3. I did *** inside him
4. I did not see any blood.
5. The sex was not hard, i.e. he was well lubricated, and I noticed nothing on my penis afterwards.
6. There had been no fisting, etc.
7. There were no sores (or the like) on my penis before or afterwards.
8. I am not aware that I had any other STDs at the time.

Questions:
1. What are the chances that I have have caught HIV from this encounter?
2. 6.5 weeks after the encounter, I was diagnosed by my doctor as having tonsillitis. I had experienced the symptoms - sore throat, white spots on the tonsils, swollen glands - a couple of days previously.  I had no other symptons generally associated with ARS, e.g. flu, fever, temperature, rash, fatigue, nausea, vomiting.  Given the timescale after possible infection and given the nature of the symptoms, how likely is it that this is ARS?  I did have a lot of other things going on at the time, and I should note that he prescribed me with antibiotics which cleared the infection up within a few days.

I am very worried, and am concerned that if I have got the infection then I may have passed it on to my wife, who I have regular unprotected sex with.  What are the chances of me having passed it on to her.  There have been instances of me cumming inside her, and also when she has been menstruating.

Thanks for your help.

[H. Hunter Handsfield, M.D.]

The main lesson is that it was dumb to have sex with the guy without asking your partner his HIV status and sharing your own.  That is the single most important element of safe sex for gay/bi men.  In my opinion, there should never be sex between two guys without discussion of HIV status.  No exceptions.  This applies even when safe sex is planned, because intentions for safety often disappear in the heat of the moment, especially if drugs or alcohol are involved.

The general estimate is that the risk of getting HIV from a single episode of insertive anal sex with an HIV infected man is somewhere around 1 in 500.  There are no data on which to estimate whether that number is changed by such things as vigor or duration of sex, quality of lubrication, intra-rectal ejaculation, etc.

Symptoms never are a reliable indicator of new HIV infection, because the identical symptoms are caused by many other things that are more common than HIV--including viral or streptococcal pharyngitis, which are the better bet for your syptoms (symptoms).  But the only way to know for sure is to have an HIV test.  All else is secondary.  Return to your provider, be honest with him/her about your HIV risks, and have an HIV test.  Most likely it will be negative.

Good luck-- HHH, MD

[anxietyX5]

This website has been very helpfull, and I'm sorry for posting on someone elses question, but I have been freaking out for 4 months now. I have been tested 5 times for HIV and the last one being at 18 weeks after the encounter (unprotected vaginal sex with unknown partner). This incident has caused me a lot of anxiety to the point where I've been drinking too much. I was starting to feel better latly except I have still been haveing symptoms like itchy rashes on my inner thighs that come and go . And I was wondering what you think about this. thank you so much for your time.

[confused_uk]

I really sympathise with you about all the anxiety you are suffering from. It is horrible.
But you should know that there is NO WAY you could possibly have HIV with a negative test at 3 months (let alone after 18 weeks).

[WorriedUS]

AnxietyX5,

Read the post immediately after yours entitled "Protected Sex Many Times with Different Prostitutes" posted 11/06/06 by forum user angstconcern, and please do read my response at the bottom. I only say that because I referred that forum user to some other threads on this site regarding what Doc H has already said regarding testing windows times. You could alternatively, type in "time to test positive HIV" and read the posts there.  

You don't need testing beyond the 6-8 week window.

Good luck

-WorriedUS

[JohnnyV]

I still think that any HIV security measure that gays need to practice should also be applied to heterosexuals. It makes no sense to say that asking about HIV status before intercourse is a must-do for guys who like guys, but an unnecessary mood-wrecker for guys who like women.

J

[H. Hunter Handsfield, M.D.]

In principle everybody should try to assure their partners are free of HIV and other STDs.  But it's a less useful exercise in the heterosexual context compared to male-male sex.  First, the chance the partner has HIV are radically different.  Second, the odds of transmission, if one person is infected, is much higher between men than between men and women.  Third, most gay/bi men have been tested relatively recently and know their status, whereas most strictly heterosexual men and women have not.  Therefore, an opposite-sex partner's assurance that s/he doesn't have HIV is much less reliable, whereas it provides a significant degree of reassurance among gay men.

To put it another way:  Gay/bi men who do not follow my advice to routinely ask partners about HIV have a high risk of catching HIV in the long run (of course, also depending on adherance to other safe sex practices).  But among heterosexual men and women, asking about HIV status probably has little influence on the long-term risk of transmission.

HHH, MD

[Brian123]

I know it is rather difficult to convey tone in reading e-mails, posts, etc. but I felt the very same way when I read your post earlier today (as JohnnyV)  did.  I did not have time to reply, but I wanted to state the same feeling reaction.  

Application of rules for "asking the partner's HIV status" should be applied to both homosexuals as well as heterosexuals.  I hope that you did not mean any disdain in your "pointing of fingers" at the homosexual crowd is no different than that of a heterosexual writing this main thread, but I would have felt ashamed based on your initial response at the onset of your original message stated above.

I do know that you may rationalize that homosexuals have a higher risk factors regarding HIV contraction of the disease, but equality is necessary for justice when messages are written to a homosexual and/or heterosexual person asking a question.

Again, I am curious to your rebuttal on this matter.

B.

[WorriedUS]

Brian,

I think the Doc means that gay/bi men can rely more on their partner's statement of their HIV status because it is a much more effective prevention method for transmission.  This is partly the case because people in the gay/bi community have been tested more.

From my understanding, that's why the doc was a tad 'doting' upon men who have sex with men without FIRST ascertaining their partner's status via questioning them.

In the heterosexual crowd, testing is not done as often and thus someone's 'word' they they are 'clean' may not be true.

Point being, questioning HIV status is an more effective prevention mechanism in one sexual community as opposed to the other.

That's all he said.  Nothing disparaging from what I gleaned.

-WorriedUS

[Brian123]

I understood the underlying meaning that was conveyed in his message to the original post.  This is what I am trying to say:

I work with students.  Let me give you an analogy:

If I only told blue-eyed students that it was "dumb" to have done what they did and furthermore when on to explain why it was (with explicative reasoning), the blue-eyed student STOPPED listening after hearing the word "dumb" and cared less what was said after.

Now, if I told brown-eyed students a great rationlization to why their answers were wrong without the use of "dumb" or any other word that berates their integrity for asking, the student is more than likely to listen to my rationalization of what was wrong with the situation/problem that led them there.

Purpose of the analogy: Words can often hurt more than the intended purpose of asking the question to start with; thus allowing the person to feel ashamed and embarrassed for asking such a personal question.

Had this been a person who was just experimenting with their homosexual orientation for the 1st time, or even had it been a heterosexual (which it was not),  I see no reason why the word "dumb" was used.  I have read many, and I mean...MANY a thread posted by heterosexual persons who talk about unprotected sex; all whereby the word "dumb" is not used.  I am just proposing continuity in his attempt to be subtle, yet non-threatening manner of approaching questions asked by persons of homosexual orientation.

I think sometimes people need to be understanding and yet tactful on how to approach and answer the quesitons,...whether it be a professional or a forum-user.

B.

[Brian123]

My apologies...this person seems to be "married"...and therefore the forum user may be "bisexual" or "experimenting".

B.

[WorriedUS]

Understood Brian,

Perhaps, a euphemism for dumb and its surrounding context would have been warranted.  But perhaps, and I do not obviously speak for the Doc, but I think he just gets really upset on how and why his fellow humans don't undertake a much more proven prevention mechanism for that subset of humans (your blue eyed students, for e.g.)

He cares DEEPLY. He is simply being doting, yet compassionate and therefore his use of the word "dumb" is used in a VERY good context.  Let's not overhype this thing.

Back in August 2006, there was a case where a forum user had (in all probability) contracted HIV by having highly risky unprotected sex with transexuals at the RIO.  I do not believe the Doc used "dumb".

Granted, communities need a different approach in learning and understanding what is and what is NOT risky behavior, but we're all adults here. Feelings aside, I think the word looks bad when taken out of context and being as is one of the foremost experts on STD transmission risks in the country and the fact that he used the word in context attempting to DRIVE his point home in the shortest amount of words possible, given that he is an extremely compassionate professional knowledgeable in this area, he would be afforded the MOST amount of leeway with that word, in my opinion.

But I do hear you as well.

Regards,

-WorriedUS

[confused_uk]

Hi all,

I appreciate everyone's input here and can truly understand where you are all coming from.
For what its worth though, I would like to say that, as a bisexual male, I take no offense at all at the Dr's remarks.
On the contrary, I am only too glad to read an expert's advice. Dr H has screened/treated tens of thousands of gay, bi and heterosexual people in his decades of experience.
If this is the advice he has formulated from his extensive experience, then that advice is priceless.

A few on the key facts I have learnt from Dr. H (some of which I did not know before due to my ignorance):

1. STDs/HIV are much more prevalent amongst gay and bisexual men, compared to heterosexuals.
2. Anal sex carries a higher risk of transmission than vaginal sex
3. Asking a gay/bisexual's HIV status is particularly useful for the reasons the Dr stated earlier.

In giving over this advice, I am sure we all agree that Dr H is doing a great service to all sexually active people, including gay/bisexuals.
I have no doubt that his work on this site (and elsewhere) has -- and will contunue to - reduce STD transmission by educating people. This will save lives.
Sometimes, good advice may not feel good for the recipient. As a bisexual male, I can tell you that Dr H's advice has seriously made me think about the precautions I need to take in order to prevent acquiring STDs, or at least to minimise the risks.
I hope I have not offended anyone - I am just giving my opinion. Feel free to comment!
Ben

[anotherdummy]

confused,
Excellent post from you and congrats for accepting the realities of this disease and not trying to delfect on to others who the stats say (time and time again) are at low risk such as heterosexuals.  

The original post is a prime example of why women are getting hiv at increasing rates.  Men who have sex with other men, then go home and have sex with their wife (without her knowledge), possibly (more than likely) even insertive anal which definitely increases the risks for a female, or anyone who is the receiver.

Anyway, I applaud you for your realistic views and your re assessment of the risks of your lifestyle.  This is a responsible approach.  The doctor here only cites stats and what he sees and has seen for 30+ years, which as you say, is priceless.  Some just choose to remain in denial to his experience and try to make it everyones problem when it is apparent by the stats it is not.  Numbers do not lie.

Your attempt to remain civil is a nice gesture, but don't worry about offending anyone or being politically correct as you owe nothing to anyone here.

Good luck to you and I hope you stay safe.

[Brian123]

I think the true reality is when we see that the heterosexual contacts for HIV are growing in alarming rates (especially among African American women).
Nonetheless, I believe that in another 5-10 years the heterosexual rates for HIV will be in accordance with the homosexual rates.  The "testing for HIV" proposal has long been proposed in the gay community, and more studies have been done/reflected on gays than heterosexuals.  The "true" rates for homosexuals with HIV is more documented than heterosexuals. This due-to-the-fact that still, after 25 years of AIDS, most heterosexuals still believe HIV/AIDS is still a "gay" disease, a poor assumption that is only becoming more fallible in light of more education on the disease. No one person can argue that homosexual contact is a more viable means to contract HIV (due to anatomical reasons.) What I am still so surprised by are the statements made by heterosexual persons who feel they are in a "safety" net from getting HIV. It is believed (according to the CDC) that approx. 1 million Americans are infected with HIV, yet, 1/3 still do not know they have it. (one of every three)

But then again, as the quote states, "There are three types of lies: lies, damn lies, and statistics".

[monkeyflower]

Well, the truth is that straight guys ARE at lower risk. Especially the straight guys who post on these forums. I even recently read an article in the LA Times about how they're now focusing their HIV prevention efforts almost exclusively on gay guys, because HIV affects gay men so much more often. That's really pissed a lot of people off, but I don't think it should. It doesn't mean HIV is a "gay disease", and it doesn't mean there's any implied judgment, discrimination, or criticism behind those facts/efforts. Quite the contrary.

I do recognize the stigma attached to STDs in general and HIV in particular, in part thanks to the still overwhelming homophobia in this country. I literally just got home from voting against a ridiculous and hugely offensive marriage amendment that will probably pass because my state is full of fundamentalist idiots (I can't WAIT to get out of the south). I personally think this homophobia and resulting discrimination is so pervasive, we become overly sensitized to it. That can lead us to see discrimination, judgment, and criticism where there really is none. I know that in my case, my lifestyle is very different from the majority, particularly where I live, and sometimes I can feel kinda sensitive and defensive about it. But I also recognize that my lifestyle does put me at MUCH higher risk (I'm female, have herpes, have sex with MSM, have multiple partners), and I wouldn't be offended at someone pointing that out. MSM shouldn't be either.

As for calling something "dumb", it's hardly like Dr. Handsfield is so much more sensitive and delicate with exclusively straight guys, lol. He tells it like it is, and that's part of why I really respect his advice and why I love this site so much. No judgment, no criticism, but no sugar-coating either. Just the facts. And that's what keeps me coming back here.

[Brian123]

Thanks Monkeyflower, ....I know I can always rely on you to calm me down.
I am over it now.

:)


B.



BTW,
Quite a few valid points in your statements there.

P.S.:  LEAVE THE SOUTH!!!   ; )

[Brian123]

Thanks Monkeyflower, ....I know I can always rely on you to calm me down.
I am over it now.

:)


B.



BTW,
Quite a few valid points in your statements there.

P.S.:  LEAVE THE SOUTH!!!   ; )

[monkeyflower]

Lol, thanks. I'm thrilled to say that our time here is limited. I'll be done with my internship after next summer, and then we're moving with one of our partners. So far it looks like San Francisco, although we're also considering Portland and Seattle. Our major qualification is that it HAS to be a liberal, sex-positive community ;-)

[anotherdummy]

Brian,
Believe whatever you like.  If I remember correctly, the Dr. has said over 1/2 the US population has been tested for HIV, I would bet that a large majority are not gay and do not participate in that lifestyle, so your theory about most hetero's not being tested really is not valid.  To imply gay males are more responsible with frequent testing is simply you trying to justify why the MSM population have repeatedly shown higher rates of HIV infection year after year.  It is a misguided implication and I would suggest the opposite.  From what I have read, alot of MSM do not want to get tested for fear of results so they do not.

I get really pi$$ed off when I see "deflections" of reality simply because deep down MSM know that they are major contributors to HIV infection.  That is fact.  Now, not all gay males are promiscuous (i.e. bathhouses, internet hookups etc)but this seems to be the contributing factor for the spread of HIV.  It takes a few to spoil it for all, again the numbers indicate this in the "MSM" category.  Again, my brother is gay and in a loving relationship with someone for many years and he himself is at low risk for HIV because of it.  I do not understand it and do not try.  I also do not accept his chosen path, but, he is my brother and I still respect him.  He also never tries to push me to accept his life even though the "politically" correct thing to do these days is just that.

My step brother is opposite.  I am quite sure he will end up with HIv if he does not have it already.  Drugs, repeated promiscuity, and high risk lifestyle total an almost guarantee.  His father was gay and passed away from AIDS from the exact same lifestyle.  He was married at the time he was having sex with other men and also going home and having sex with his wife, such as the original poster).  This was late 70's early 80's.  Thankfully, she did not get infected.

[anotherdummy]

brian said"I think the true reality is when we see that the heterosexual contacts for HIV are growing in alarming rates (especially among African American women)."

Any HIV med professional I have spoke to has said the same thing to me, and that is is it extremely rare they see a hetero male getting HIV unless having repeated sex with an HIV positive woman, been in jail, and/or using shared needles. They have also repeatedly said the majority of women get HIV from IV drug use, and receptive anal/vaginal from MSM.  These comments have been made to me on completely separate occasions and different locations and follow almost exactly what the doc here says.

  I would be confident in saying a strictly "hetero" male getting HIV is an extremely rare occasion,like it or not.

[H. Hunter Handsfield, M.D.]

I'm not going to continue to participate in this thread.  I'll just point out that I have made similarly assertive statements many times before, although usually buried toward the end of my responses and not the opening words, which might have increased the statement's visibility.  "Dumb" may seem insensitive, but its benefit--drawing attention to the issue--is evident from all the responses.  Truly, male-male sex without exchanging HIV status really makes no sense to me--i.e., "dumb" doesn't seem inaccurate.  People shouldn't take such statements personally; my replies to all questions are intended not only for the questioner, but to the broad range of forum users.

The current and anticipated continued growth of heterosexual transmission of HIV is clear.  But there are and always will be differences in HIV risk for male-male compared with female-male (or female-female) partnerships.  Among other things, most heterosexual transmissions in industrialized countries occur between regular partners, whereas most HIV infections in gay men probably are acquired from casual, non-committed partnerships.

So most likely Brian is wrong about the notion that heterosexual risks will someday equal those for gay men.  But he is entirely right that many infected people are unaware of their infections, and these are the predominant transmitters of infection to their partners, gay or straight.  (It's closer to 1 in 4 infected people who don't know, not 1 in 3--but that's hair-splitting.)

As usual, monkeyflower's comments are insightful and accurate.

HHH, MD

HHH, MD

[Brian123]

Seems to me you have an irrational fear of homosexuals. Your homophia is only perpetuated by the statements you stated by your brother's lifestyle.
Such is life that ignorance stands in the world.
And most of your thread, stated by homosexuals not wanting to get tested is a rash generalization. You apparently do not seem to be up-to-date on issues in this country.

[anotherdummy]

Its the same old story.....Why is it that those who have an opinion such as I do, are the ones who must always try to "understand"?  Why do you not understand, that I choose not to try to understand?  It has nothing to do with fear , homophobia etc.NOTHING!  The only time I have a problem is when people of "special" interest groups try to force people to understand or accept their life choices.  The gay pride parades are prime examples such as this thread is.  

The point is (again) I really have no interest in understanding the gay lifestyle.NONE!  Go ahead and life your life but it does not mean everyone has to accept and understand it just because you do.

I am not politically correct.  I can't help it if you don't like that or find it arrogant, it's my choice, just as it is yours to think I am arrogant. I would suggest the same though, that maybe you should work to understand my thoughts or don't respond.

Regardless, I am done here as I can't seem to "make" you see things my way. ;)

[anotherdummy]

An typical response simply because I do not have any interest whatsoever in why a man wants to have sex with another man.  It has nothing to to with "irrational fear" as you describe it.  

I like to get in a ring and fight with other men.  I also like to stick needles in my a$$ and inject steroids then go lift heavy weights.  Do you undearstand why?  If not you must have a fear of violence and steroids right?, yet I don't try to jam it down your throat to make you understand either such as you appear to attempt to do.

Such is life that ignorance stands in the world.

[anotherdummy]

For those who may feel the doc is singling out gay males with his "dumb" dialogue.....maybe this will make you feel better.

http://www.medhelp.org/forums/HIV/messages/391.html

[monkeyflower]

I think that what Brian was noting may have been your remarkable lack of empathy and attempt at understanding another person's perspective. Your comments are awfully arrogant and judgmental, and feel homophobic to me as well.

The simple fact is, gay, bi, or straight, people are people. Gay folks aren't any different from you. They want the same things you want (and more than a few also inject steroids and fight other men, JUST LIKE YOU). The only difference is that they want to love and have sex with someone of a different gender.

I'm sorry if that makes you uncomfortable. In the future, I suggest that rather than judge people for who they love, either work to accept it or just don't respond.

[Worried Of Birmingham]

Hey Guys, just wanted to let you all know that I plucked up the courage to go for an HIV test, and it came back negative.

I just consider myself very lucky, and the whole worry surrounding this has given me such a scare that the thought of ever practising unsafe sex again makes me feel rotten to the core.

And, by the way, I'm not offended by the use of the word "dumb".  I am dumb for doing what I did.  It was totally avoidable, and nothing is worth putting yourself through that sort of agony.

Please keep safe everyone, and just enjoy.

[o_g]

Congrats...Although, I wonder if anyone who contributed to this thread is around anymore if they haven't gotten their heads chewed off already. Suddenly, everyone is souding like an expert here. I hope Doc got enough money saved up for the retirement as the current crop of young forum users are giving a damn good competion with their expertise in testing and transmission..ehm...

Doc - Best Of luck. Don't worry ... soon we gona have a democrat president n economy will recover enough to create other employment opportunities ;-)

[Brian123]

First, Nobody gives a flying s-h-i-t about your political views.
Secondly, your an idiot and a fool.

[o_g]

hmm. somebody is in a bad mood...
Well, good to know you don't give a flying whatever but thanks for taking out the time and reading my postings and also replying to them. It seems you give lot more than flying **** or whatever. Hats (n finger between ring and index finger) off to you... Peace ;)...

[o_g]

Its really OK that you are gay...thats not a problem...
The problem is that your are really a dumb gay. I hope that counters the fool and idiot part. Ciao

[Trankie]

A related discussion, My risk? was started.

[worriedman34]

A related discussion, Scared to death was started.