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"Active" Anal Sex Participant
Oct 3, 2006

On a Friday night a couple of weeks ago, I had an HIV exposure. Not to put too fine a point on it, I was at a bathhouse, and this guy put my penis in his anus without a condom. (It was very dark, and I thought he was putting it in his mouth.) This went on for maybe five minutes before I realized what was going on, at which point I withdrew before ejaculation. While I never asked this man his HIV-status, I can't imagine anyone engaging in that kind of reckless behavior could be negative.

The next night I paged my primary doctor and asked him what I should do. He told me to go to the emergency room. I did, and the ER doctor asked me in a very hostile manner why I was there for this. Regardless, he prescribed Viracept and Combivir.

The next Tuesday, I followed up with my primary doctor. He consulted an infectious disease expert who said that I should continue the medications for three months.

No one ever bothered to assess my risk factor. (The ER doc was a jerk, and my doc just doesn't have the experience with HIV infection, which is why he called a specialist.) Was my exposure enough to warrant antiviral treatment? And, if so, should I be on the course for three months?

I'd really appreciate your response. Thank you so much for taking the time to do this!!!

I'm sorry for the long question, but I remain... Scared & Alone in Hollywood

Response from Dr. Frascino

Hello,

It must have been very dark indeed for you not to know the difference between a hummer and backdoor action, but OK . . . .

Gosh, and then you apparently went from asshole to asshole by having to put up with that ER doc! He should reevaluate his career choice if he doesn't understand the emergency nature of a potential HIV exposure! And he practices in Hollywood, frevinsakes!

PEP is indeed warranted for your type of exposure. However, a full course of PEP is 28 days, not three months. I'd suggest you consult with a competent (and hopefully more compassionate) HIV specialist to evaluate and document your HIV risk, optimize your PEP (Viracept + Combivir is OK, but not my first choice for PEP), manage any PEP-related side effects/toxicities and arrange for post-PEP follow-up testing. To find a certified HIV specialist in your area, check the American Academy of HIV Medicine's Web site, www.aahivm.org. They have a roster of certified HIV specialists listed by locale.

Don't be scared. And you aren't alone. I'm here if you need me, OK?

Good luck.

Dr. Bob



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