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HIV Prevention (Expert Forum)
Past risky behavior
by ATrueWorrier, Jun 11, 2006 12:00AM
Hi,
I'm a 24 yo, gay black male. For the past almost 2.5 years, I've been practicing abstinence. My decision to do so stems from a couple years of very bad, "stupid" decisions.
Around the 2001-2002 I had an oral sexual encounter that led to me contracting both gonnorhea and chlamydia. (I know right---it sucks). The doctor treated me and tested me for everything else, and said I should be ok. Although he didn't exactly tell me if I was tested for HIV also, but didn't make a point to tell me i needed to be either.
Anyway, since that encounter, I had three episodes of unprotected insertive anal sex. I know it was really stupid, and i hate myself for it every day. All guys claimed to be clean, and I believed them...but then there's always that doubt in the back of my mind. All the episodes were very brief. The first one only lasted a matter of minutes, because I was just uncomfortable. The second one, I was only without a condom for a few minutes before I stopped and asked to put one on. And the third one was after being with the guy for almost a year and a half in a relationship. None of the episodes involved inside ejaculation. (These three separate incidents all happened one time each for a 1.5 year period. - oh and none of the other men were black---if needed for statistical reasons.)
Like I said, I know I was stupid. That's why I made the decision to stop sex completely. I didn't want to keep going on like that.
I know being gay, black, uncircumcised, all doesn't help me. I am very happy with being abstinant, but I still face a terrible amount of guilt, shame, and fear from my past mistake. By nature I tend to worry alot.
I am very happy for going on almost 2.5 years with no sex. But the past still screams loud in my head. The anxiety has really been killing me lately...(can't eat, can't sleep, unfocused at work).
If you could please give me an estimate of what my chances of being HIV free are, I would greatly appreciate it.
Thanks...
I'm a 24 yo, gay black male. For the past almost 2.5 years, I've been practicing abstinence. My decision to do so stems from a couple years of very bad, "stupid" decisions.
Around the 2001-2002 I had an oral sexual encounter that led to me contracting both gonnorhea and chlamydia. (I know right---it sucks). The doctor treated me and tested me for everything else, and said I should be ok. Although he didn't exactly tell me if I was tested for HIV also, but didn't make a point to tell me i needed to be either.
Anyway, since that encounter, I had three episodes of unprotected insertive anal sex. I know it was really stupid, and i hate myself for it every day. All guys claimed to be clean, and I believed them...but then there's always that doubt in the back of my mind. All the episodes were very brief. The first one only lasted a matter of minutes, because I was just uncomfortable. The second one, I was only without a condom for a few minutes before I stopped and asked to put one on. And the third one was after being with the guy for almost a year and a half in a relationship. None of the episodes involved inside ejaculation. (These three separate incidents all happened one time each for a 1.5 year period. - oh and none of the other men were black---if needed for statistical reasons.)
Like I said, I know I was stupid. That's why I made the decision to stop sex completely. I didn't want to keep going on like that.
I know being gay, black, uncircumcised, all doesn't help me. I am very happy with being abstinant, but I still face a terrible amount of guilt, shame, and fear from my past mistake. By nature I tend to worry alot.
I am very happy for going on almost 2.5 years with no sex. But the past still screams loud in my head. The anxiety has really been killing me lately...(can't eat, can't sleep, unfocused at work).
If you could please give me an estimate of what my chances of being HIV free are, I would greatly appreciate it.
Thanks...
Doctor's Answer
by H. Hunter Handsfield, M.D., Jun 11, 2006 12:00AM
, Jun 11, 2006 12:00AM
The behaviors and exposures you describe indeed imply risk for HIV, but statistically it seems low. Your circumcision status modestly increases your risk, but not much.
Your being black is completely irrelevant. Rates of HIV are higher in African Americans than in other race/ethnicity groups in the US because of overall patterns of behavior and potential exposures. But this cannot be used judge any particular person's risk; your own behavior is all that matters in assessing the likelihood you are infected.
The only way I can answer your question is like this: What are the odds of HIV infection in an uncircumcised gay man who has had only a few unsafe insertive anal sex encounters and a few episodes of unsafe oral encounters, including at least one that resulted in acquiring an STD? Perhaps it is obvious that no specific data are available. But if those are your only potential exposures, the chance you have HIV cannot be more than 1 in several hundred. If I knew you were HIV negative when tested a couple of years ago, I would say even lower. But almost certainly you were not. Few if any providers of STD care in the US would test someone for HIV without the patient's understanding and consent--which someone who "tends to worry a lot" surely would remember.
But why you're asking instead of just getting tested? That's obviously the answer. Do not tell me it will be too stressful. While I understand that response, I have no patience with it. Nothing, not even a positive result, can be as stressful as worrying and not knowing. Do it immediately.
Best wishes-- HHH, MD
Your being black is completely irrelevant. Rates of HIV are higher in African Americans than in other race/ethnicity groups in the US because of overall patterns of behavior and potential exposures. But this cannot be used judge any particular person's risk; your own behavior is all that matters in assessing the likelihood you are infected.
The only way I can answer your question is like this: What are the odds of HIV infection in an uncircumcised gay man who has had only a few unsafe insertive anal sex encounters and a few episodes of unsafe oral encounters, including at least one that resulted in acquiring an STD? Perhaps it is obvious that no specific data are available. But if those are your only potential exposures, the chance you have HIV cannot be more than 1 in several hundred. If I knew you were HIV negative when tested a couple of years ago, I would say even lower. But almost certainly you were not. Few if any providers of STD care in the US would test someone for HIV without the patient's understanding and consent--which someone who "tends to worry a lot" surely would remember.
But why you're asking instead of just getting tested? That's obviously the answer. Do not tell me it will be too stressful. While I understand that response, I have no patience with it. Nothing, not even a positive result, can be as stressful as worrying and not knowing. Do it immediately.
Best wishes-- HHH, MD
I needed that "virtual kick in the pants." It's true that to relieve the anxiety of not knowing, you just have to go and find out. I went today to get an OraQuick Rapid HIV Test. I couldn't bear to wait another 2-3 weeks. So in 20 minutes I got the results...and I was Hiv-negative. What a relief!!! And because I've been practicing abstinence for the past couple years, I can rest assured that the results are accurate.
I'm really relieved. You guys do good work here. Lots of useful info and very fast responses. hopefully, I can persuade alot of my other friends to get tested, and go with them as support. And I definitely won't be making the same mistakes that caused me to worry in the first place.
Thanks
HHH, MD