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HIV Risk?
Doctor, I had protected insertive m2m anal sex with an anonymous person 5 weeks ago. I have to assume that he was HIV positive as he wanted to receive without any protection. This was at an adult theater frequented by men who have m2m sex. I had shaved my genital area approximately 2 hours before this encounter and noticed after the m2m encounter that there was an open sore approximately one eight of an inch in diameter from shaving at the base of my penis which was not covered by the condom. I did not see any blood, but the sore probably made contacted with his anus. Ten days after the encounter, I have developed a headache which continues to date at the 5 week mark. No other symptoms (fever, sore throat, swollen glands etc) are present. I have read that since I was protected, the risk is low but the headache has me very concerned since I rarely have headaches and never had one lasting this long. I plan to get an HIV test at the 8 week mark but the wait and headache is worrisome. What was my potential risk and is the headache indicative of a potential initial HIV infection? Thanks.
MEDICAL PROFESSIONAL
I think our last two comments crossed each other; I already acknowledged the error, not realizing your sex with protected. (Your comment that your partner sought unprotected sex made me think that's what happened, missing your opening description that it was protected.)
This information means your risk of HIV was quite low. Perhaps a bit higher than otherwise because of the penile lesion, but if it wasn't actively bleeding, probably not enough to make any real difference.
This information means your risk of HIV was quite low. Perhaps a bit higher than otherwise because of the penile lesion, but if it wasn't actively bleeding, probably not enough to make any real difference.
Thank you for the quick reply. It is reassuring to know that the risk was low. It certainly reduces my anxiety as I wait another week to test.
I am not sure but I believe you may have misunderstood - this was incredibly stupid but this was NOT unprotected sex. I just assumed, but don't know, that the guy was HIV positive as he wanted to receive without protection. I DID use a condom the entire time. My concern is the potential to contract HIV through the sore (cut) at the base of my penis. The sore was due to shaving approximately 2 hours before the event but noticed 30 minutes after the event. Can herpes form a sore in 30 minutes? Does this explanation change your interpretation fo the even and the HIV risk potential?
Thanks so much for your reply.
I will get tested next week ( 6 week mark) for all STD's.
Thanks so much for your reply.
I will get tested next week ( 6 week mark) for all STD's.
MEDICAL PROFESSIONAL
Oops -- thanks to insanely_worried: I misread the exposure as UNprotected anal sex. You would not have qualified for PEP, and your risk for this exposure was in fact low risk. A single HIV test at this time will be sufficient.
However, I strongly advise you still follow the other suggestions, i.e. discuss HIV status before proceeding in similar situations. Sometimes condoms are forgotten in the heat of the moment, and sometimes they break. With or without condoms, you should ask about HIV status.
However, I strongly advise you still follow the other suggestions, i.e. discuss HIV status before proceeding in similar situations. Sometimes condoms are forgotten in the heat of the moment, and sometimes they break. With or without condoms, you should ask about HIV status.
Don't mean to hijack your thread, but how is protected insertive sex such high risk even with an anonymous man?
MEDICAL PROFESSIONAL
Welcome to the HIV forum. I'll try to help.
Wow. This was a foolishly high risk exposure. I'm not sure I would assume your partner had HIV merely because he prefers being bottom in anal sex -- many people simply prefer some sexual practices more than others. But any male who has sex with other men anonymously and in settings like adult theaters, bath houses, parks, etc is among the highest of the high risk. Had you sought medical attention promptly of the exposure (within 3 days), you would have been a candidate for post-exposure prophylaxis (PEP) with anti-HIV drugs to reduce the risk of infection.
The best estimate for HIV transmission risk for anal sex between men has been estimated at around 1 chance in 500 for the insertive (top) partner, if the receptive (bottom) partner has HIV. The sore at the base of your penis might have elevated the risk, especially if it was due to herpes (by far the most common cause of otherwise unexplained penile ulcers). Happily, however, your symptoms do not suggest a new HIV infection, which does not cause headache as the only symptom.
The modern HIV tests now in routine use are almost always positive by 6-8 weeks after onset of a new infection, so you can be tested at any time. If negative, as I expect it to be, you should have another antibody test at 3 months, just to be sure -- although it is very rare for tests negative after 6 weeks to show positive at 3 months. But in very high risk situations like this one, it makes sense to be extra sure.
I hope you realize you are playing with fire. You probably dodged the bullet this time. But please avoid anonymous contacts in the future -- or if you continue them, use condoms for anal sex and ask about HIV status before having sex (and don't go ahead, even with condoms, with those who say they are positive, haven't been tested recently, or seem evasive about it). If you cut corners on any of these common-sense rules, you should expect to have HIV someday.
Going back to your penile sore: If for sure you caused it by shaving, then herpes isn't a likely cause. But if you assumed shaving without recalling an actual cut, herpes is a good bet. If so, please get it checked out.
Please return with a follow-up comment to let me know your test result.
Good luck-- HHH, MD
Wow. This was a foolishly high risk exposure. I'm not sure I would assume your partner had HIV merely because he prefers being bottom in anal sex -- many people simply prefer some sexual practices more than others. But any male who has sex with other men anonymously and in settings like adult theaters, bath houses, parks, etc is among the highest of the high risk. Had you sought medical attention promptly of the exposure (within 3 days), you would have been a candidate for post-exposure prophylaxis (PEP) with anti-HIV drugs to reduce the risk of infection.
The best estimate for HIV transmission risk for anal sex between men has been estimated at around 1 chance in 500 for the insertive (top) partner, if the receptive (bottom) partner has HIV. The sore at the base of your penis might have elevated the risk, especially if it was due to herpes (by far the most common cause of otherwise unexplained penile ulcers). Happily, however, your symptoms do not suggest a new HIV infection, which does not cause headache as the only symptom.
The modern HIV tests now in routine use are almost always positive by 6-8 weeks after onset of a new infection, so you can be tested at any time. If negative, as I expect it to be, you should have another antibody test at 3 months, just to be sure -- although it is very rare for tests negative after 6 weeks to show positive at 3 months. But in very high risk situations like this one, it makes sense to be extra sure.
I hope you realize you are playing with fire. You probably dodged the bullet this time. But please avoid anonymous contacts in the future -- or if you continue them, use condoms for anal sex and ask about HIV status before having sex (and don't go ahead, even with condoms, with those who say they are positive, haven't been tested recently, or seem evasive about it). If you cut corners on any of these common-sense rules, you should expect to have HIV someday.
Going back to your penile sore: If for sure you caused it by shaving, then herpes isn't a likely cause. But if you assumed shaving without recalling an actual cut, herpes is a good bet. If so, please get it checked out.
Please return with a follow-up comment to let me know your test result.
Good luck-- HHH, MD
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