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Big Slip Up - Anal with Poz

Sep 21, 2005

Dr Bob,

while on a slightly drunken night this week (three cocktails), i had insertive anal sex as the top without a condom with a man i believe to be HIV+. he had the sunken-face, very-muscular, no-fat look about him.

it was for about a half hour with a lot of deep thrusting. no blood visible, no fecal matter, either. i did not ejaculate.

this was really out of character for me. i enjoy anal sex a lot and have used condoms for over 18 yrs (i'm 42, came out at 25)

i'm worried because i've been running a slight fever, 99.1, since yesterday (Friday).

also had safer sex with a regular sex partner the day before this incident. that guy then emailed me to tell me he had a cold develop the next day.

i have been tired and run down with less sleep since last week, before either encounter above. working a lot and staying up late.

so i'm confused and worried, not knowing if i'm having conversion illness or just run down and catching a cold from my other sex buddy.

so what is your advice?

what is PEP? i read about it in some other responses.

my doctor has a large HIV practice and i have no problem relating this info to him but i wanted to ask you first.

philly slip up

Response from Dr. Frascino

Hello Slip-Up Phil,

The risk of acquiring HIV from unprotected insertive anal sex with someone confirmed to be HIV positive is estimated to be 6.5 per 10,000 exposures.

PEP stands for Post-Exposure Prophylaxis. It involves taking antiretroviral drugs for 28 days following a significant HIV exposure in an attempt to abort or decrease the risk of acquiring HIV. PEP should be started as soon as possible and no later than 72 hours after the exposure.

My advice to you, since you are outside of the PEP window and you don't know the status of your partner (despite his "HIV look"), is to get HIV tested at the three-month mark. Symptoms, no matter what they are, are notoriously unreliable in predicting HIV infection. The reason to get HIV tested is the risk of exposure, not the presence of symptoms.

Everyone makes mistakes, Philly-Guy, even yours truly. The important thing is to learn from our mistakes.

Good luck. Stay safe. Stay well.

Dr. Bob

getting AIDS
Sex with horses

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