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Being a Top
Oct 21, 2005

I am a bottom once in awhile with people who I defintely know what thier HIV status is, which is negative. I am an escort, and although I don't allow any of my clients to penatrate me, I've been the top, and been the insertive. I start out with a condom on, and take it off toward the middle and end. After sex, I always take a tetracycline for 48 hrs. What is my risk for contracting HIV?

Response from Dr. Frascino

Hello,

A couple of points need to be cleared up here immediately:

1. If you remove the condom during sex, you are having unprotected sex, which places you at risk for STDs, including HIV.

2. Tetracycline is an antibiotic and has no protective effect against HIV whatsoever. It also does not protect you from a variety of other sexually transmitted disease either.

3. The estimated per-episode risk for acquiring HIV from unprotected insertive (top) anal sex is 6.5 per 10,000 exposures to an infected source. That risk increases to 50 per 10,000 exposures to an infected source for receptive (bottom) anal sex.

4. For all types of sexual activity, the risk of acquiring HIV is greater for the receptive partner than for the insertive partner.

5. At the present time, you are not protecting yourself or your clients from STDs, including HIV.

6. I recommend you use latex condoms and water-based lubricant from start to finish each and every time you have sex, whether it be professional or personal. In addition, you need HIV and STD screening immediately. If negative, you'll need to repeat your HIV-antibody test three months or more after your last potential exposure to confirm you are indeed HIV negative. Finally, I recommend you spend some time reading the information on this and related sites pertaining to HIV prevention and safer sex techniques. At this point, the most important thing you are escorting is potential disaster!

Get informed! Stay well. Stay safe.

Dr. Bob



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