hi Dr. Bob!

First I'd like to say thanks for all the work you do on this site. From what I can tell you seem to have plenty of insight and a very optimistic attitude that seems to help more than hinder which is a lot different than the other sites I've been on. Hopefully you can help me out though cause even with combing through the archives I haven't been able to find any information concerning my situation...

I'm a 27yo male and since mid-January I've been with 4 guys (yeah I know, not proud of myself)all of those encounters involved unprotected insertive oral and three of them protected insertive anal with no obvious condom failure.

Now after the second encounter (late Febuary) I noticed some slight discomfort while urinating but didn't think much of it. It wasn't until a day after the fourth encounter (late March) that I noticed a slight discharge. I panicked and went to a local clinic and got put on some antibiotics for a possible NGU, still got about a week until I get the results from the swab back.

Well my concern comes from the last encounter I had. while doing the deed (which included insertive oral and protected insertive anal) it became apparent that he was heavy into inhalants as I saw him huff out of a can of compressed air and poppers. I decided to cut the act short and even though he said he was clean, after talking to him it seemed he doesn't really take much cause to insist on protection with his partners and pretty much left it up to them to choose. Thank god I wore a condom! But now I'm worried that the chances that the guy was HIV+ were pretty high and with that how much of a risk could the oral have been?

I'm assuming that my STD screen will come back positive for clap or NGU from one of my other unprotected oral encounters. Does having a preexisting STD increase your chances of getting HIV that much more? Hopefully I can get a speedy response as I'm worried and it's still at least 7 weeks before I could woohoo as you put it...

The Worried Busybody

Hello Worried Busybody,

I'll make several points related to your post.

1. Poppers and other inhalants can decrease inhibitions and consequently lead to increased risk behaviors. Your little-brown-bottle guy seems to illustrate this point very well.

2. Unprotected insertive oral sex carries only a negligible risk for HIV acquisition.

3. Yes, having a concurrent STD can increase the likelihood of HIV transmission/acquisition. However, in your specific case I should point out you still don't have a firm STD diagnosis. Plus, you were already on antibiotics for some period of time before bachelor #4 showed up. An HIV test at the three-month mark is warranted.

4. Four guys since mid-January doesn't make you a busybody. I've seen dudes knock off more guys than that in a single night out here in San Francisco. Remember the most important factor is playing safe! OK?

Good luck. Be well.

Dr. Bob