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AH MAN! NOT ANOTHER ONE OF THOSE QUESTIONS!!
Oct 9, 2007

Hi doc, a perplexed puppy here. In my semi-short sex life, I've always been careful about being safe. I've been testing regularly and actually just got a neg result last week. I've been a good boy...well, you know what I mean. The reason I'm writing to you now is I need your wisdom and professional opinion. I feel this is not new for you but I'm sure nothing is new for you, right? And for me, I feel very anxious and I have to make a decision QUICK! I just had sex with a guy I've met a couple years ago. I felt confortable with him and like him. He sadly got infected, he said, almost 2 years ago by his unfaithful ex-boyfriend. (BTW, this is the third person I know who go infected through their cheating partners. It's fucked up!!) Anyhow, now my worries is that he told me his change of status AFTER we had sex which of course got me SUPER WORRIED. During our passionate sex, I definitely got precum (and my god, did he have plenty!!!) in my mouth and also he poked around my asshole without penetrating too deep (it felt maybe the tip of the head in?)..but again he is a precummer! It might be too much information but I had a bout of diarrhea a few days ago which makes me think that maybe my asshole might not be in the best shape. Microfissures??? What would you advice a patient that comes in your office with this info. He also told me that he is healthy and not on any meds yet which could mean higher viral levels, right? PLEASE PLEASE PLEASE advice me. Would you urge me to seek a doctor for PEP in this case?!? I'm really confused with the risks in this case, and the choice I need to make. I need a big hug too...even virtually Sorry to be nutcase

Pup who's been good so far but screwed up

Response from Dr. Frascino

Hello Perplexed Puppy,

Unfortunately you picked an inopportune time to need my help, as I've been cyber-challenged while traveling for the past week or so. So the question of to PEP or not to PEP is no longer relevant. So let's focus on your overall HIV risk and what you need to do next, OK?

Your risks are oral receptive sex without ejaculation but with plenty of precum and "maybe the tip of the head in" receptive unprotected anal sex with an HIV poz partner.

Precum does contain HIV and can transmit the virus; however, the amount of virus in precum is generally much lower than in spunk and consequently the transmission risk is also much lower. As for the tip of the head, well, if he got "in," even briefly, that could potentially transmit the virus. However, since the exposure was so minimal and brief, the actual, rather than theoretical, risk is extremely low. At this point your next step is to get an HIV-antibody test at the three-month mark. The odds you did not get infected remain astronomically in your favor. However, I should also remind you that we all must consider that our sexual partners could be HIV positive and take all the necessary precautions to stay healthy each and every time we get the urge to merge and surge! That way if Mr. Hotty McFastpants forgets to mention he's HIV positive until after popping his cork, you won't have any post-nookie worries, OK?

I'll send you my very best cyber-hug and good-luck/good-health karma that your test is negative.

Be well.

Dr. Bob



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