Hello, Dr. I have read your answers in past months answering some of my questions from my participating in next to no risk situations and being paranoid. I really do apprecaite what you do on here. Last night I had my first real scare where i was the receptive in anal sex with a guy who I did not know was positive at the time, but later found from a friend heavily suspects is positive based on his past actions.

We were participating in sex when his condom broke in me and he pulled it out after about 10-15seconds. He later ejaculated inside me but did so inside another condom that did not break as he pulled out intact with the semen inside of it.

My question is is the risk of the brief 10-15 seconds of him being inside me without ejaculation and very likely without pre-cum or any fluid at all put me at much less risk then unprotected anal sex.

And do u think PEP treatment is necessary if he is confirmed to be positive considering this risk? (under 10 hours ago)

Many thanks much appreciated!

Hello,

Unprotected (or broken-condom) receptive anal sex carries the highest risk for sexual transmission of HIV. That your exposure was brief (10-15 seconds) and did not include unprotected ejaculation in the anal canal would decrease your risk somewhat, but certainly not eliminate it.

If your partner is confirmed to be "virally enhanced," PEP would be recommended if it could be started immediately (and no later than 72 hours from the time of the exposure). If your buddy's rapid HIV test is negative, PEP would not be indicated.

Good luck.

Dr. Bob