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Proactive?
May 20, 2005

Dear Dr. Bob, first thanks for your great website/Q&A. I ran across it researching for my situation. I had unprotected anal sex (active & passive) one week ago for the first time with a guy I originally met at a bath house. I did not ejaculate in him but he partially did in me. It is a week later and I have not heard from him and am wondering what I should do since he has not returned my calls and I do not know his status.

I am trying to be sane and assume that based on the little he shared that he is negative. But considering the who, where and how I think there is cause for some concern. I do not have any sypmtoms but understand it may be a little early to see any. I have not been to my doctor and my plan is to be tested at 4 and 12 weeks and 6 months per CDC recommendations and meditate a whole lot. Should I see my doctor about initiatiing a post exposure prophylaxis or is it too late? If I move the 6 month test up to 3 months and am neg am I good to go? I like to be proactive (you would not have guessed if you knew there where condoms in the drawer a foot away) and want to know if I should be doing something other than giving myself a kick-in-the-butt for being so stupid. A word of wisdow to the other hopeless romantics, practive safe sex EVERYTIME unless you know with 100% certainty that your partner is safe, monogamous and honest!

Signed, made a big mistake and hope all I end up with is my broken heart.

Response from Dr. Frascino

Hi,

I agree the "who, where, and how" are of concern. You placed yourself at risk for STDs, including HIV, and consequently do need to be tested. Testing prior to week 12 would not be considered definitive and, consequently, is not recommended.

Post-Exposure Prophylaxis (PEP), when indicated, should be started as soon as possible, and no later than 72 hours, after the exposure. Since you are at least one week out, this is no longer a recommended option for you.

Is a kick-in-the-butt warranted? Sure, particularly because the condoms were only a foot away! However, don't be too hard on yourself, OK? We are all human. That means, be definition, we all make mistakes. Yes, even yours truly.

Even though anal receptive sex is the "riskiest" behavior, the odds are still very much in your favor that you did not contract HIV. Testing, however, is still definitely warranted.

I'm sending you my very best good-luck karma that your tests will be negative.

One way or the other, I'm here if you need me, OK?

Dr. Bob



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