HIV concerns?

[justchecking65]

I think I have the answers just based on reading this site. I had my first — and only — sexual encounter this past week. I'm a male living in Iowa and I received unprotected anal sex twice in one night from the same guy — it is my first and only sexual experience. We were drunk (incredibly stupid) and he was unable to *** either time. Although the guy I hooked up with has been permiscuous, he assures me has taken an HIV/STD test as recently as december, all of which have come back negative. He takes them every three months, but said he always practices safe sex, except with me because he trusted that I had never been with another man. I do trust the guy — as much as you can for someone you've known for only a week — and he assures me he has never had any HIV scares, he just wants to err on the side of safety. But the fact that he has been with other guys is a cause for concern. If I read other posts correctly, the risk from a single sexual encounter is low. Just wondering if my case applies to this situation. Plus, any advice for when I should take the HIV test and whether I should be overly anxious.

[H. Hunter Handsfield, M.D.]

The likelihood you acquired HIV from that encounter is very low. Your partner probably isn't infected (because most people don't overtly lie about such things, and because it seems he probably practices safe sex, thus unlikely to have become infected since December); and even if he was, the likelihood of transmission for any single encounter is low.  Patterns of behavior indicate HIV risk more than individual events.  There is less certainty, however, about other STDs.  But you do not say what sexual practices took place:  oral, anal, insertive, receptive.

If there was no anal sex, you can consider the encounter nearly totally safe.  But if there was anal sex, regardless of who was top, bottom, or both, then your partner's decision to not use condoms because YOU had no chance of infecting HIM sounds pretty self-centered.  Safer sex is a 2-way street, and even if the chance he has HIV or any other STD is low, it isn't zero.  Is the risk high enough for you to be tested for HIV or other STDs?  Probably not.  But nobody can say the risk was truly zero.

So not counting masturbation, you started your sex life with a mixed picture of safety.  Knowing HIV status and sharing it with partner, a big plus.  Non-use of condom for anal sex in a non-monogamous setting, a definite minus.  (If oral sex only, a big plus.)  Another basic element of safer sex among gay men is to avoid sex with someone you just met the same night; but you don't say whether you knew this guy before or met him in the bar, so either a plus or a minus here.  Finally, having sex in the context of being high on alcohol or drugs--a definite minus.

Bottom lines (no pun intended):  A learning experience that might serve you well.  Follow the guidelines implied in the paragraph above and you'll likely live forever, uninfected by HIV.  The occasional lapse and you're still probably OK.  But consistent unprotected anal sex with new partners in context of drugs and alcohol and you could expect to acquire HIV somewhere along the line, regardless of how safe each individual encounter seems to be.  As a general guide, most gay men ought to be tested for HIV and common STDs at least once a year; if very high risk, every 3 months; somewhere in the middle, twice a year or so.

Stay safe--  HHH, MD

[justchecking65]

Thanks doc, this site has been an incredible resource. By the way, I met the guy online about two weeks ago, we talked on the phone three or four times and went on a real date (so I hope that gets me another plus in addition to all those minuses). I hope you know what a great service you are providing. Thanks again.