HIV Risk?

[socal1985]

Hey Doc,

I had a possible HIV exposure about a month ago and am really worried and just wanted to get your opinion since I can't seem to find an infectious disease doctor who has an appt. anytime soon.  

I am a gay male and went to get a massage from a gay male.  He gave me a massage, then jumped on me and was rubbing his penis up against my anus for a few minutes, not very long.  He put oil in my butt before he did this.  I don't think there was any entry as there was no pain, and he was quite large.  I didn't notice much precum on him after this either.  My major concern is that I get blood spots on my toilet paper once in awhile from wiping too hard so I know that I have anal fissures or hemorrhoids sometimes but I hadn't felt any pain or seen any blood for a few days before this episode, so I don't think there were any open wounds.  There was no ejaculation for either of us.  Immediately after the massage, I showered and cleaned the area and still didn't see any blood.  Unfortunately after it was too late, I decided to ask him his HIV status and he said he was positive but undetectable for the last 5 years and is on meds.  

I freaked after this and was trying to seek advice about PEP but was referred to visit the emergency room.  They weren't helpful either but did give me a weeks worth of PEP which I took.  

1.  What do you think my risk from this single episode of anal rubbing was?  
2.  Do you think I need to follow the pep testing guidelines given the fact that I only took it for a week?

I appreciate your help doc.  I'm really freaking out about this.  

[Edward W Hook, MD]

As you know, you have posted on the wrong site.   Questions about HIV belong on the HIV prevention site.  I will do my best to answer your questions with this reply but, if you have additional questions or follow-up they must be on the HIV Prevention site.  Sorry.

Without penetration this risk of acquiring HIV from your infected partner is virtually zero, even with chronic hemorrhoids or an anal fissure. Furthermore, the risk of HIV transmission is proportional to the amount of virus present in a person's blood and if your partner was on proper HIV therapy and undetectable, the risk of transmission, even if there had been penetration is also very, very low.  

I would not have given you PEP for a non-penetrating exposure of the sort you describe. Further, it really bothers me when people give PEP without arranging for follow-up or give PEP in improper doses of for improper durations.  If you have finished the PEP they gave you at this time, I would not restart if there has been an interval of more than a day. if you are still taking it and there has not been a break I taking it , you have decide whether you will take it for the proper 3 week duration or not.  

Hope this helps.  Your risk form the exposure you describe was virtually zero.   EWH

[socal1985]

Sorry, I think I miscategorized this and am not sure how to fix it.