Foolish Behavior

[jack76]

I am a gay male, 30 y/o.  I met a man @ a massage parlor who performed oral sex on me, then fingered my anus. He was masturbating himself first with the hand that he penetrated me with.  Later, he briefly (15-20 seconds) penetrated me without the use of a condom…..then the thought of HIV/AIDS entered into my mind.  After the 30 seconds of penetration, he pulled out and put on a condom. He re-entered for about 5 min….pulled out and put on a new condom. At the end, he did  not ejaculate.

What are your thoughts on pre-seminal fluids being a possible infection for HIV based on the first scenario?    I asked him if he was tested and negative for HIV….and he responded that he was tested and negative. He also stated that he does not do much “anal sex” if that means anything at all.

There have been no multiple partners and I had been tested in the past...most recently in July...and it was neg.  Prior to that...I have always been safe.

Thank You.

[H. Hunter Handsfield, M.D.]

Amoxicillin would have substantially reduced the risk of gonorrhea or chlamydia, if your partner were infected--but not 100% certain.  It would definitely prevent syphilis.  A negative Home Access test at 4-6 weeks would be highly reassuring, but a final test at 3 months would be needed to be 100% certain.

HHH, MD

[jack76]

It was amoxicillin. I reead the script.

[jack76]

I was on a general antibiotic for an upper respiratory infection. Would that have cleared any possibility for ghonnorhea, chlamydia or syphilis exposure.

I searched the archives for the Home Access question and found my answer.. THANK YOU.

[H. Hunter Handsfield, M.D.]

Glad you agree.  Didn't mean to lecture you above--but I was writing my reply above before you posted this comment.

HHH, MD

[jack76]

Thank you for such a quick response.

May I ask one follow up question PLEASE?

Would a Home Access test @ 4  or 6 weeks give me a baseline for and idea?

Thank You AGAIN!

[H. Hunter Handsfield, M.D.]

There are no data on whether HIV transmission through anal sex is mediated by semen, pre-ejaculate fluids (pre-***), or both.  The assumption is semen is important, but nobody really knows.  Unprotected receptive anal sex, even if brief and without ejaculation, is high risk sex by any definition.  The risk is probably lower than with more prolonged exposure and without ejaculation, but nobody can say how much lower.  However, most people don't lie when asked directly about their HIV status, so the odds are strong that your massage parlor partner didn't have HIV.

So on balance, your risk from this event was low. However, I suggest you take this event as a lesson:  you had better get in the habit of aking people about their HIV status BEFORE having sex with them; refusing sex with those who are positive or won't say (or act evasive); and avoiding unprotected sex (and especially not letting anybody penetrate you without a condom) unless you know for a fact he is HIV negative.  If you don't stick with that program, it's a good bet you'll catch HIV someday.

Good luck-- HHH, MD

[jack76]

BTW,
I understand fully that condoms should ALWAYS be used for sex (anal, vaginal). My question is regarding the probability of pre-seminal fluids being a theoretical or more-than-likely possibility for HIV infection.  I never want to go through this again for 30 seconds of unprotected penetration.