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Transmission risks and statistics
Hi - first off, thank you for being here. This site has a wealth of information and I am glad that I stumbled upon it.
While engaging in sexual activities (oral sex, minimal rimming and kissing) things got a little carried away. Although we had no intension of having anal sex, while in the heat of the moment, things got a little out of hand. I was the active (top) partner in brief anal sex. Shortly after being inserted I climaxed while inside. The extent of the anal intercourse was very brief. The activities occurred approximately 10 days ago in Germany.
I am curious about:
- the risk of transmission for a circumsized active partner during anal sex and how that statistically compares to vaginal intercourse.
- if the strands of HIV in Europe are similar to those in the US and if our tests will be able to trace infections from Europe.
While engaging in sexual activities (oral sex, minimal rimming and kissing) things got a little carried away. Although we had no intension of having anal sex, while in the heat of the moment, things got a little out of hand. I was the active (top) partner in brief anal sex. Shortly after being inserted I climaxed while inside. The extent of the anal intercourse was very brief. The activities occurred approximately 10 days ago in Germany.
I am curious about:
- the risk of transmission for a circumsized active partner during anal sex and how that statistically compares to vaginal intercourse.
- if the strands of HIV in Europe are similar to those in the US and if our tests will be able to trace infections from Europe.
MEDICAL PROFESSIONAL
To clarify: being UNcircumcised increases the risk for the insertive partner; being circumcised modestly reduces it.
MEDICAL PROFESSIONAL
Welcome to the HIV forum.
I'm going to start with a little lecture. You describe exactly why asking partners about HIV status, and sharing one's own HIV status BEFORE starting sex ("do ask, do tell") is such an important element of safe sex for men who have sex with men -- just as important as condoms for anal sex. Intentions for safe sex often go by the wayside in the heat of the moment, as happened with you. Knowing a partner has HIV, or that he is evasive in answering, won't necessarily prevent such encounters from progressing to unsafe levels -- but it sure helps! Stick with "do ask, do tell" and you'll likely never catch HIV. Continue to ignore it and it's a good bet that HIV is in your future.
You likely know all that, but maybe reinforcing it will help you stick with the program. And with luck, other forum users also will benefit from the message.
Now to the specific questions. The data show that if one male partner has HIV, the statistical chance of transmission averages around 1 in 200 for transmission from the penile (top) to anal (bottom) partner, around 1 in 500 in the opposite direction -- i.e., for you, around 1 in 500 if your partner had HIV. This is about 4 times higher than the risk for the penile partner in vaginal intercourse (around 1 in 2,000).
There are no data on whether these risks are altered for long versus short exposure times -- logically yes, but probably not much. These are very rough figures; they could be underestimates if your partner or you has another STD, especailly herpes; or overestimates if the infected person is on anti-HIV therapy and/or has a low viral load. Circumcision also increases the risk for the penile partner, but not by all that much.
Any way you slice it, the chance you were infection was not trivial. If you had known your partner had HIV and had sought care within 72 hours, you would have been a candidate for post-exposure prophylaxis (PEP) (another reason for "do ask, do tell"). But still, the odds are in your favor. You should see a doctor or clinic with experience in HIV testing in general and in diagnosis of early HIV infection in particular. For sure you need HIV antibody tests at around 4-6 weeks and again at ~3 months. Some experts would also recommend testing for p24 antigen and/or for the virus itself by PCR testing. See an experienced provider then follow his or her advice about the details.
Good luck--- HHH, MD
I'm going to start with a little lecture. You describe exactly why asking partners about HIV status, and sharing one's own HIV status BEFORE starting sex ("do ask, do tell") is such an important element of safe sex for men who have sex with men -- just as important as condoms for anal sex. Intentions for safe sex often go by the wayside in the heat of the moment, as happened with you. Knowing a partner has HIV, or that he is evasive in answering, won't necessarily prevent such encounters from progressing to unsafe levels -- but it sure helps! Stick with "do ask, do tell" and you'll likely never catch HIV. Continue to ignore it and it's a good bet that HIV is in your future.
You likely know all that, but maybe reinforcing it will help you stick with the program. And with luck, other forum users also will benefit from the message.
Now to the specific questions. The data show that if one male partner has HIV, the statistical chance of transmission averages around 1 in 200 for transmission from the penile (top) to anal (bottom) partner, around 1 in 500 in the opposite direction -- i.e., for you, around 1 in 500 if your partner had HIV. This is about 4 times higher than the risk for the penile partner in vaginal intercourse (around 1 in 2,000).
There are no data on whether these risks are altered for long versus short exposure times -- logically yes, but probably not much. These are very rough figures; they could be underestimates if your partner or you has another STD, especailly herpes; or overestimates if the infected person is on anti-HIV therapy and/or has a low viral load. Circumcision also increases the risk for the penile partner, but not by all that much.
Any way you slice it, the chance you were infection was not trivial. If you had known your partner had HIV and had sought care within 72 hours, you would have been a candidate for post-exposure prophylaxis (PEP) (another reason for "do ask, do tell"). But still, the odds are in your favor. You should see a doctor or clinic with experience in HIV testing in general and in diagnosis of early HIV infection in particular. For sure you need HIV antibody tests at around 4-6 weeks and again at ~3 months. Some experts would also recommend testing for p24 antigen and/or for the virus itself by PCR testing. See an experienced provider then follow his or her advice about the details.
Good luck--- HHH, MD
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