|INSERTIVE ANAL SEX / HIV TRANSMISSION redux
Feb 19, 2006
Hello, Dr. Bob! Surfing just now to answer my query, I was googled your/our way, as I am an electronic What's New at the Body subscriber. You have addressed this issue at least twice, and I excerpt below. Pardon, but could you clarify a/o confirm my understanding, as below. TIA. You have written: "... I can say your overall per episode risk of contracting the virus is less than .1-.3 per-cent. " and "1. Condom failure places you at some degree of risk for STDs, including HIV.
The estimated per-act risk of acquiring HIV from unprotected insertive anal sex with a partner confirmed to be HIV positive is 6.5 per 10,000 exposures.... Q: Dr. Frascino, in the foregoing, second sentence, The estimated per-act risk etc., this meanS the estimated per-act risk to the SERO-NEGATIVE, UNPROTECTED INSERTING PARTNER, i.e., the top, right? Does this 6.5% per 10k exposures thus break down to your 2002 per-episode statistical response to a similar inquiry of ".1 - .3 percent"? Mathematically challenged, anxious to accurately assess risk inherent to inserting partner (were a monogamous, late 50-ish couple eschweing condoms) and Thanks, Dr. Frascino, for your clarification. I know unprotected sex, whenever, is attended by risk, that its playing Russian roulette and in no way do I promote such practices. As a couple, however, we have the question. Thanks again. Dana Oakland, CA
| Response from Dr. Frascino
Being that you're mathematically challenged, let me keep this simple. You want to know the risk of an HIV-negative top barebacking an HIV-positive bottom, correct?
The best I can do is offer you an estimated statistical risk, emphasizing this is only a general estimate. There are a wide array of variables, such as viral load and concurrent STDs, which can affect any one person's individual degree of risk. That said, the estimated per-act risk for an HIV-negative top acquiring HIV from having unprotected insertive anal sex with an HIV-positive bottom is 6.5 per 10,000 exposures.
I, too, cannot and do not promote unsafe sexual practices; however, I can offer you information that HIV-transmission risk is significantly decreased when the positive partner's HIV viral load is reduced to undetectable levels.
Stay safe. Stay well.
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