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total top
Jul 1, 2006

I don't believe the 6.5 to 10,000 chance of a HIV neg top getting HIV from a poz bottom. I foolishly barebacked and converted in early 2005, I figured those huge odds were on my side (his anal blood would have to come into contact with my penile blood, more or less, what's the chance of that?, if it could be transmitted through mucous membrane we'd get HIV from kissing..etc) I have since talked to other total tops who were infected the same way. Obvioulsy accurate statistics are hard to establish. I think there's a lot more to transmission than we know about.

Response from Dr. Frascino

Hello,

The 6.5 per 10,000 exposures estimate is the best estimate we have based on large-scale epidemiological studies. Please note this level of risk is per episode! Consequently, yes, the huge odds were on your side, but that degree of risk is still highly significant and HIV can indeed be acquired with only a single exposure, as you unfortunately discovered.

Your concept of how HIV is transmitted via insertive anal sex is incomplete. The mucous membrane of the urethra can actively absorb HIV from anal secretions (or blood) and transport it across its intact surface! It does not require penile trauma or penile blood. This is not the same situation as kissing, in which many other factors come into play, including the effect of saliva, concentration of HIV, less chance of mucous membrane trauma, etc.

Your post should serve as a stark reminder to all who feel the odds of bareback topping are an acceptable risk. They clearly are not!

Thank you for writing in and sharing your experience. It may very well prevent others from getting infected from relying on a false sense of security that is based on anecdotes from barebacking tops that (so far) are still negative, statistical estimates that may be difficult to interpret and a misunderstanding of the basic mechanisms involved in HIV transmission.

Regarding HIV transmission, we actually know a great deal. The problem is relating that information in a coherent, understandable and scientifically rigorous way.

Good luck on your journey with HIV. I urge you to continue to help educate others as to the true risks of unsafe sex.

Dr. Bob



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