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Anal sex
Oct 29, 2002

I am really worried because I had unprotected anal sex with a male prostitute a couple of days ago, October 26 to be exact. He is about 20 years old and claims that he had a test a month ago and turned out to be negative. If ever he was infected after his test,after a month or so, is it possible that he can transfer the virus to me. How long does an HIV virus become fully transmittable? Are there any medications, drugs or theraphy that I can engage in, if ever I am infected, during the first few weeks of HIV infection?

Response from Mr. Kull

If you have unprotected anal sex with a man who has sex with other men and you are not sure of his HIV status, you should consider yourself at risk for HIV infection. It is important that you get tested three or more months after your exposure and that you practice safer sex with future sexual partners.

It is possible that a person could transmit HIV within days after infection. The first month following infection could pose a more significant risk for infection because viral levels in bodily fluids are very high. This is why you should avoid basing your safer sexual practices on what someone says about their HIV status (especially if you don't know them well) and just use condoms.

Receptive anal sex is considered higher risk than insertive anal sex. Post-exposure prophylaxis--the use of antiviral medications within 36 hours of exposure to prevent infection--is indicated for those who have receptive sex (usually to ejaculation) with an HIV infected person or person of significant risk.

Since your exposure could be of significant risk, consider talking with your doctor or someone experienced with HIV to monitor your health. If you manifest symptoms of acute illness, treatment could be initiated early to reduce the level of virus in your body. Starting treatment during acute infection has demonstrated long-term benefit in some studies.

I don't mean to be alarmist, but it is important that you know all of the resources available to you. Don't forget the importance of evaluating the circumstances surrounding the episode of unprotected sex. People aren't perfect and might neglect condom use once or twice, but a situation which represents a pattern in your life needs to be better understood to reduce your risk for HIV infection.

RMK



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