hiv risk with most likely positive partner

[caballoazul]

This past weekend, I met this guy who I think is HIV positive, he says he's negative as of March, but his lifestyle tells me otherwise (party with drugs, been involved with people who had escort before, and dated hiv + people in the past) and I'm just going with my gut feeling.

Anyway, we had anal sex twice (i was the receptive partner) with a condom, didn't break and had no contact with his sperm.  I did gave him a ******* twice and I did taste some precum, not much but enough to taste it a couple of times. I also deepthroated him, and we used some poppers as well.

I'm totally freaking out and I need some sort of guidance at this point, thanks a lot for you help beforehand. thanks a lot!!

[Edward W Hook, MD]

I hope that my comments will be helpful to you.  First let me congratulate you on discussing issues of risk with your partner.  That is exactly the right thing to do and I applaud it.  Having said that, let me also point out that we get many questions from clients who, after the fact, decide that they do not trust recent sex partners.  Our experience tells us as well that in the majority of such instances, the concerns are misplaced because most person do tell the truth. In your instance, why would this person tell you of his prior "adventures" as well as that he has dated others with HIV and then lie to you about his infection status.  The plain and simple fact of the matter is, the majority of such persons DO tell the truth.  

But what if he wasn't?????????  Well if he wasn't telling the truth or if he had acquired HIV in the interim since he was last tested, your risk remains quite low because you did the "right things" to protect yourself.  Specifically, correct condom use is highly effect in preventing HIV even if your partner was infected, transforming a potentially high risk exposure into a low risk one.  Use of condoms for receptive rectal sex makes your risk from that exposure very close to zero.

As for your other exposures, oral sex and "deep throating" really have very little (as in close to zero) risk, even when unprotected.  The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.

Bottom line, you are doing things right. The exposures you describe are very, very low risk and you have done the right things. I certainly see no particular reason to worry or for concern.  Similarly no reason to worry about emergent testing or other preventative measures.  hope this helps.  EWH

[caballoazul]

I greatly appreciate your prompt response. I will take this learning to heart. Thanks for your time Dr. Hook!