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First Time Insertive Anal Barebacking: PEP Necessary??

May 13, 2008

Hey Bob, I made a big mistake about 48 hours ago, I engaged in insertive anal sex with a transexual prostitute.

Maybe in 3 months, I'll be able to chalk it up as my stupid learning experience, but maybe not, I realize there's a degree of russian roulette with things like this.

Should I be getting my ass to a doctor that does PEP ASAP?? (within 24 more hours, since it's already been 48 hours). I'm in Japan, where despite it being a 'developed' country, is not always up to date with things like this.

You might not be able to get to this question with me asking it so late, and you might be sleeping now with the time zone difference, but whether you do or not, thanks so much for everything you do and helping people throughout the world through the internet.

Response from Dr. Frascino


No doubt unprotected anal sex places you at some degree of risk for STDs, including HIV. The question of whether to undergo a course of PEP or not would depend on many factors, including the likelihood that your partner is HIV positive, the presence of any concurrent infections that might increase transmission risk, local trauma during sex, etc. An HIV specialist would take this type of detailed history in determining your actual degree of HIV-acquisition risk. Depending on that assessment, PEP may or may not be recommended. Unfortunately by now this may well be a moot point for you, as I believe you are now beyond the 72-hour cutoff for institution of PEP. Consequently I would recommend you get an HIV-antibody test at the three-month mark and learn from this experience that sex is always cleaner with a packaged wiener!

Good luck!

Dr. Bob

hi karma again
hiv negative

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