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Receptive anal sex
I am a gay male. Recently, I had receptive anal sex (bottom) by another male of unknown status. Unknown because he has never been tested. We used a condom. After the sex I examined the condom and it seemed to be intact. I think the condom stayed during the entire sex and it did not slip off but I am not 100% sure because my partner had it off at the end of the sexual encounter. My concerns are the following:
1) Before putting on the condom on my partner, during foreplay, my partner did put pressure on my anal area with his penis (without a condom) - just the tip or the head of the penis. Later on during the actual sex a condom was used. Can this be a concern for infection?
2) What are the chances that I can become infected if the condom was used correctly and stayed on during the entire sex?
3) How effective is an HIV test after 4 weeks?
4) What are my odds according to my described situation in contracting HIV?
Thank you,
Concerned 0877
1) Before putting on the condom on my partner, during foreplay, my partner did put pressure on my anal area with his penis (without a condom) - just the tip or the head of the penis. Later on during the actual sex a condom was used. Can this be a concern for infection?
2) What are the chances that I can become infected if the condom was used correctly and stayed on during the entire sex?
3) How effective is an HIV test after 4 weeks?
4) What are my odds according to my described situation in contracting HIV?
Thank you,
Concerned 0877
MEDICAL PROFESSIONAL
A negative result at 25 days is ~90% reliable. For close to 100% certainty, have another test at 6-8 weeks.
That's definitely all for this thread. You don't need to post negative test results, which obviously cannot alter my advice. I will delete any further comments without reply.
That's definitely all for this thread. You don't need to post negative test results, which obviously cannot alter my advice. I will delete any further comments without reply.
MEDICAL PROFESSIONAL
It seems pointless to speculate about things that didn't happen. But since you ask, the data suggest an average transmission risk for unprotected anal sex somewhere around 1 in 200 for the bottom partner if top is infected.
That will be all for this thread. I won't have any further comments.
That will be all for this thread. I won't have any further comments.
MEDICAL PROFESSIONAL
The DUO test was only approved by FDA 3-4 weeks ago for marketing in the US, but it takes a while for labs to rev up, order the test kits, etc. Undoubtedly most labs will have the DUO available soon; you'll just have to ask around. In the meantime, probably almost any lab can do separate HIV antibody and P24 antigen tests, although it might be expensive.
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help.
Congratulations on your apparent commitment to safe sex, indicated by condom use. However, if you asked about your partner's HIV status before you had sex, and still proceeded despite his not knowing -- well, that was really dumb. Keep it up, and there's a good bet HIV is in your future. For gay/bi men, avoiding sex with people known to be positive or who don't know is just as important as consistent condom use for anal sex.
OK, lecture over. I don't really mean it as a lecture, and don't take it personally. I just take every opportunity to say it again and again. I call it "Do ask, do tell".
Despite the lecture, you really have no serious worries about any particular exposure. Statistically, it is probable your partner doesn't have HIV. And if he does, the fact is that condoms work. There is no such thing as microscopic leaks through intact latex or polyurethane; in the absence of an overt condom rupture, protection is complete.
To the specific questions:
1) It is penis inside rectum that creates the risk, especially with ejaculation. Non-insertive sex carries little if any risk.
2) No risk; see above.
3) With standard HIV antibody tests, about 90-95% of newly infected people have positive results by 4 weeks. If you have the newly marketed (in the US) Duo test -- which measures both HIV antibody and the P24 antigen, a marker for the virus itself -- then a negative result is virtually 100% reliable. A duo test at 4 weeks is likely to become the gold standard for post-exposure HIV testing.
4) Nearly zero risk for this particular exposure. But please don't take similar chances in the future. Follow my "lecture" advice and use condoms consistently for anal sex. If you do both, you can expect a lifetime without ever catching HIV.
Best wishes-- HHH, MD
Congratulations on your apparent commitment to safe sex, indicated by condom use. However, if you asked about your partner's HIV status before you had sex, and still proceeded despite his not knowing -- well, that was really dumb. Keep it up, and there's a good bet HIV is in your future. For gay/bi men, avoiding sex with people known to be positive or who don't know is just as important as consistent condom use for anal sex.
OK, lecture over. I don't really mean it as a lecture, and don't take it personally. I just take every opportunity to say it again and again. I call it "Do ask, do tell".
Despite the lecture, you really have no serious worries about any particular exposure. Statistically, it is probable your partner doesn't have HIV. And if he does, the fact is that condoms work. There is no such thing as microscopic leaks through intact latex or polyurethane; in the absence of an overt condom rupture, protection is complete.
To the specific questions:
1) It is penis inside rectum that creates the risk, especially with ejaculation. Non-insertive sex carries little if any risk.
2) No risk; see above.
3) With standard HIV antibody tests, about 90-95% of newly infected people have positive results by 4 weeks. If you have the newly marketed (in the US) Duo test -- which measures both HIV antibody and the P24 antigen, a marker for the virus itself -- then a negative result is virtually 100% reliable. A duo test at 4 weeks is likely to become the gold standard for post-exposure HIV testing.
4) Nearly zero risk for this particular exposure. But please don't take similar chances in the future. Follow my "lecture" advice and use condoms consistently for anal sex. If you do both, you can expect a lifetime without ever catching HIV.
Best wishes-- HHH, MD
Doc,
I know you said that was it for this thread , but today I went for my HIV test and it came back negative at 25 days since the incident described above. Is 25 days sufficient enough time (just shy of 4 weeks), and have you ever seen anyone test negative at around my time and then become positive? Should I test again?
Thank you!
I know you said that was it for this thread , but today I went for my HIV test and it came back negative at 25 days since the incident described above. Is 25 days sufficient enough time (just shy of 4 weeks), and have you ever seen anyone test negative at around my time and then become positive? Should I test again?
Thank you!
If I may, I'd like to rephrase question # 4. If no condom was used or if it had broken during anal receptive sex, and my partner is HIV +, what are the odds that I could have contracted the HIV virus in this particular sexual act of receptive anal sex (bottoming)? Thank you.
Thank you Doc. I have another question. I live in Miami, Fl. How do I go about finding or requesting the Duo test -which measures both HIV antibody and the P24 antigen?
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