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risk of exposure and pep
Apr 11, 2008

I was intimate with a man one week ago. I opened the condom when I thought the time was right but he suggested that I just rub my penis between his but cheeks. After a few minutes of this, and my getting close, he impaled himself on me. I came quickly inside him but had no condom on. I was shocked and confused but I immediately urinated and washed. Within 24 hours I began to take Kaletra and Truvada as was prescribed for me after a similar unfortunate episode last year. I'm scared, I'm stressed and I'm confused. I didn't know the other guy and have to assume he was HIV+. Can you offer me some realistic assessment of my chances of getting infected and if I have done everything I could to minimize the risk?

Response from Dr. Frascino

Hello,

". . . He impaled himself on me. I came quickly inside him but had no condom on. I was shocked and confused . . . ." Dude, impaled himself on you??? This sounds like you are an innocent bystander lawn dart rather than active participant in a horizontal mattress mambo with a horned-up hottie!!! Making matters even a bit more unbelievable is the fact you just happened to have some Kaletra and Truvada left over from "a similar unfortunate episode last year." WHAT??? Now just how often do other dudes decide to "impale" themselves on your throbbing tallywhacker???

So first things first. It's time you started taking responsibility for exactly whom your one-eyed monster decides to impale and whether he's "dressed" for the occasion! Next, unprotected sex does place you at risk for STDs, including HIV. Consequently an HIV test at the three-month mark is indeed warranted.

Finally, as to whether you've done everything you could do to minimize the risk, the answer is no, of course not. You should have latex wrapped your wiener before it went into the hot buns (so to speak).

By the way, I do hope that now that you are taking PEP you will consult with an HIV specialist to follow you through your 28-day course. He will document your risk, optimize the PEP regimen if necessary, evaluate and manage any PEP-related side effects/toxicities and arrange for and interpret all post-PEP HIV tests (out to six months).

Good luck.

And remember, no more excuses about being an innocent bystander while others amuse themselves on your joystick!

Dr. Bob



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