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Need advice HIV Anxiety
Hi all,
I very recently had sex with a male sex worker, I always practice safe sex and this is the first time I've had sex in a year - my last HIV test last month was negative. We had vigorous sex for around two hours. During this time I performed oral sex on him several times and we had anal sex (I was passive) 4 times. We used a fresh condom for each round of anal sex (changing it almost each time he fully withdrew from my anus). The sex was quite vigorous and rough and to my knowledge none of the condoms broke or failed - I managed to test three of them with water afterwards and they were intact. The escort gave me several enemas to make things cleaner and more hygenic (using his douche which he hadnt used recently and he washed it and smeared it with antispectic gel first). There was also a lot of kissing and exchange of a lot of saliva. In terms of oral sex I have chapped lips and a tingling spot on my lips which seems inflamed i.e stingy but doesnt appear to be bleeding or open - I also bite my cheeks unconciously - this has me worried although I dont think I have any open wounds as such.
He did not ejaculate at all and didnt seem to produce any pre-ejaculate. Later that day I had some very slight bleeding from my anus.
After the session was finished we were talking and I asked the escort his HIV status which he told me he was positive - on treatment and currently undetectable. He told me not to worry as he didnt put me at risk of HIV - I wasnt too concerned initially as we practiced safe sex but anxiety shortly began to set in as this is the first time I have had sex with a confirmed HIV+ person. My questions are:
1) Are any of the details above worrisome in terms of hiv infection?
2) Is the oral sex and anal sex detailed above a huge risk?
3) Is saliva/urine in eye an HIV risk?
4) Would you recommend that I seek PEP?
5) If you were me would you be concerned? Would you take PEP in my circumstances?
6) Do I need an HIV test?
I very recently had sex with a male sex worker, I always practice safe sex and this is the first time I've had sex in a year - my last HIV test last month was negative. We had vigorous sex for around two hours. During this time I performed oral sex on him several times and we had anal sex (I was passive) 4 times. We used a fresh condom for each round of anal sex (changing it almost each time he fully withdrew from my anus). The sex was quite vigorous and rough and to my knowledge none of the condoms broke or failed - I managed to test three of them with water afterwards and they were intact. The escort gave me several enemas to make things cleaner and more hygenic (using his douche which he hadnt used recently and he washed it and smeared it with antispectic gel first). There was also a lot of kissing and exchange of a lot of saliva. In terms of oral sex I have chapped lips and a tingling spot on my lips which seems inflamed i.e stingy but doesnt appear to be bleeding or open - I also bite my cheeks unconciously - this has me worried although I dont think I have any open wounds as such.
He did not ejaculate at all and didnt seem to produce any pre-ejaculate. Later that day I had some very slight bleeding from my anus.
After the session was finished we were talking and I asked the escort his HIV status which he told me he was positive - on treatment and currently undetectable. He told me not to worry as he didnt put me at risk of HIV - I wasnt too concerned initially as we practiced safe sex but anxiety shortly began to set in as this is the first time I have had sex with a confirmed HIV+ person. My questions are:
1) Are any of the details above worrisome in terms of hiv infection?
2) Is the oral sex and anal sex detailed above a huge risk?
3) Is saliva/urine in eye an HIV risk?
4) Would you recommend that I seek PEP?
5) If you were me would you be concerned? Would you take PEP in my circumstances?
6) Do I need an HIV test?
MEDICAL PROFESSIONAL
Mouth ulcers alone, without other symptoms, are not worrisome with respect to ARS. But if you remain concerned, see doctor or clinic.
Hi Doctor,
I wonder if I could ask one more quick question then I'll shut up. Around two weeks after this exposure I started getting some mouth ulcers, no other obvious symptoms - is this worrisome or suggestive of ars? I'm thinking in the possible event that there was an unnoticed condom breakage this could be ars manifesting?
Thanks
I wonder if I could ask one more quick question then I'll shut up. Around two weeks after this exposure I started getting some mouth ulcers, no other obvious symptoms - is this worrisome or suggestive of ars? I'm thinking in the possible event that there was an unnoticed condom breakage this could be ars manifesting?
Thanks
Yes Sir,
I did read the blog - very good news.
Thank you for your help.
I did read the blog - very good news.
Thank you for your help.
MEDICAL PROFESSIONAL
That makes transmission very unlikely. Did you read the news blog about it? You definitely don't need testing or PEP.
Hi Doctor,
The escort was on treatment - Atripla - with high CD4 counts and an undetectable viral load. Does this make a difference?
Thanks
The escort was on treatment - Atripla - with high CD4 counts and an undetectable viral load. Does this make a difference?
Thanks
MEDICAL PROFESSIONAL
Welcome to the forum.
From your description, you had entirely safe sex. However, you were playing with fire for having sex, especially anal sex, with a known HIV positive person. Condoms do break sometimes, you know! Did you also ask him whether he is on treatment for HIV? If not, you should do so now; if he is taking anti-HIV drugs, the chance of transmission is markedly lower than otherwise. (Click on the information about it on Today's Pulse at the upper right of this web page.) Still, in the future I suggest you ask about HIV status before having sex with anyone and not go ahead with sex with those who are positive, don't know, or seem evasive about it -- or at least avoid anal sex with such persons.
To your specific questions.
1,2) Having said that, oral sex carries little or no risk. The important thing is that condoms were used for anal sex and did not rupture.
3) Urine and saliva are generally not infectious for HIV. Both fluids inactivate the virus.
4,5) I would not recommend PEP and I would not do it if I were in your situation. However, guidelines for PEP are quite variable, and some experts might disagree. You might want to check with a local clinic or physician who is familiar with local guidelines.
6) You apparently have HIV testing routinely from time to time. That remains a good policy. From a strictly medical or risk assessment perspective, I see no need for testing on account of this exposure. But since you are worried, you probably should do it. My guess is a negative test result would reassure you more than my words can do.
Good luck-- HHH, MD
From your description, you had entirely safe sex. However, you were playing with fire for having sex, especially anal sex, with a known HIV positive person. Condoms do break sometimes, you know! Did you also ask him whether he is on treatment for HIV? If not, you should do so now; if he is taking anti-HIV drugs, the chance of transmission is markedly lower than otherwise. (Click on the information about it on Today's Pulse at the upper right of this web page.) Still, in the future I suggest you ask about HIV status before having sex with anyone and not go ahead with sex with those who are positive, don't know, or seem evasive about it -- or at least avoid anal sex with such persons.
To your specific questions.
1,2) Having said that, oral sex carries little or no risk. The important thing is that condoms were used for anal sex and did not rupture.
3) Urine and saliva are generally not infectious for HIV. Both fluids inactivate the virus.
4,5) I would not recommend PEP and I would not do it if I were in your situation. However, guidelines for PEP are quite variable, and some experts might disagree. You might want to check with a local clinic or physician who is familiar with local guidelines.
6) You apparently have HIV testing routinely from time to time. That remains a good policy. From a strictly medical or risk assessment perspective, I see no need for testing on account of this exposure. But since you are worried, you probably should do it. My guess is a negative test result would reassure you more than my words can do.
Good luck-- HHH, MD
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