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Insertive Risk
Jan 5, 2007

A couple of days ago I had sex with a guy I met at the gym. He and I have being having a relationship for over a year. For the first time, I had sex with him without a condom. I am a top. I ejaculated inside him twice that night. I know that it was not the smartest thing to do.

Now I am worried because one of the guys at the gym said that saw him at a support group for men with HIV.

It has been a couple of days. What are my risks of contracting HIV? Should I confront this guy? Is it too late for PEP?

Please advise.

Response from Dr. Frascino

Hello,

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. PEP would be warranted if he was indeed HIV infected and if PEP could be started within 72 hours of the exposure. (PEP is most effective when started as soon as possible after a significant HIV exposure.)

Should you confront him? That's up to you. The important thing to realize is that the mistake was primarily yours. You decided to have unprotected sex, thereby risking your health. Sure, your partner carries responsibility as well, but in my opinion, we all must take personal responsibility for our own health. Your partner certainly also took a risk, as he could never be absolutely certain that you don't have an STD or HIV. Talking openly about the risk you both voluntarily took would be better than confronting him with a hearsay allegation about his status.

Good luck to you both!

Dr. Bob



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