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Barebacking & Rimming
May 10, 2002

1 week ago I had unprotected sex with a member of a Broadway show. We did some rimming and I topped him. I'm uncircumcised. Ever since, I experienced diahrrea and gas. He affirms he is healthy and clean, but still I'm concerned cuz he is from NYC, travels alot, and frequents gay.com (hook ups). Is the diahrrea and bloatness normal? How long should I wait to get tested for HIV and other STD's?

Response from Mr. Kull

Men who have unprotected anal sex with men are at significant risk for infection. The receptive partner in anal sex is at greater risk than the insertive partner (top), but the top is still at risk for infection. The odds for infection in one episode of unprotected sex with an HIV infected person are low, but compared to heterosexual sex in the U.S., the relative risk is much higher. See What is the risk for a top....

Since you had unprotected anal sex with a man, getting tested for HIV at three or more months after your exposure is important. It is also important that you try to use condoms for sex to protect your partners from any STIs you may have contracted.

Getting tested for STIs besides HIV is a bit tricky. There is no single "screening" for STIs since all are diagnosed in different ways. The usual rule of thumb is to see a doctor if you experience symptoms that may be related to STIs (ulcerations, discharge, burning, or pain in the genital region are some symptoms). The time frame from exposure to symptoms varies in each STI.

Experienced clinicians should be able to diagnose herpes and HPV by looking at the lesions. Chlamydia and gonorrhea are diagnosed by taking a sample of cells from the urethra or through urine tests, but these tests are not as accurate in the absence of symptoms. Syphilis and hepatitis can be diagnosed by a blood test. As a man who has sex with men, you should consider being vaccinated against hepatitis A and B virus. See your physician to talk more about diagnosing and treating STIs.

Rimming poses little risk for HIV transmission. There is only one documented case of transmission through rimming (probably through oral contact with blood in the rectum). See The latest on rimming for more information.

It could be useful for you to consider the reasons why you had unprotected sex in this situation. Is there a pattern? If not, why did it occur in this one instance? Were there drugs or alcohol involved? Was it something about this particular person or interaction? Asking yourself these questions, or talking it out with another person, could help you understand the motivation better, and make you more conscious of using a condom the next time you are in a similar situation.

RMK



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