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unprotected sex - level of risk for HIV transmission
Nov 11, 2002

I recently had unprotected anal sex with my partner, however it only lasted 30 seconds and ejaculation didn't take place. I didn't appear to be bleeding and my partners viral load is currently at a low level. Since this happened I have been very worried and I know that I cant test for the next three months. Do you think what we have done carries a high level of risk for me or should things be ok?

Response from Mr. Kull

Unprotected anal sex as the receptive (bottom) partner with an HIV infected person is the most efficient way to transmit HIV sexually. Ejaculation in the body carries the most significant risk, but HIV can still be transmitted through contact with pre-ejaculate.

Any time HIV infected fluids come into contact with mucous membranes (like the lining of the rectum), transmission is possible. While cuts or sores can facilitate transmission, they are not necessary for transmission to occur. This is why condoms should be used each and every time you have anal sex with an HIV infected partner.

This does not mean that you were definitely infected in this one exposure; the fact that the exposure was brief, your partner didn't ejaculate inside of you, and his viral load is low is all in your favor. However, it is advisable that you have contact with a doctor who has experience with HIV to discuss early detection methods and treatment options in case you are infected.

It is important for people in serodiscordant relationships to know that there are options for early treatment interventions in cases like yours. See my response to Unprotected Sex.

It's also important that you and your partner talk about what happened. It's really hard to have protected sex ALL of the time with a partner, even if one person has HIV. To reduce the odds of it happening again, have a caring and honest conversation about it. If this is too difficult, consider seeking out third parties to facilitate the discussion.

RMK



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