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Unprotected anal sex
Apr 26, 2001

I recently had an unsettling experience, wherein I had unprotected oral and anal sex with a sex worker. The anal sex was momentary, perhaps 20-30 seconds in all, and the sex worker had lubed herself up to the point where I could hardly tell where my penis was. IN any event, after the fact, I was highly concerned but the sex worker assured me repeatedly that she was completely clean, tested at least six months ago, had a very select clientele and at 500 an hour, well, she was a high-class sex worker. Since then, I saw her once more, mainly to talk, and she even said she would send over her medical tests to prove it and spent even more time assuring me. Anyway, given that there was no broken skin, blood, or anything like that in evidence, what are my chances now of contracting HIV?

Response from Mr. Kull

Insertive sex carries less risk than receptive sex, but having unprotected insertive anal sex does put you at risk for HIV infection and other sexually transmitted infections. Insertive anal sex probably carries more risk to the inserter than insertive vaginal sex because of the likelihood that blood would be present (you don't necessarily have to see it for it to be present; sight is not always a reliable method for assessment). Performing unprotected anal sex for a short time probably puts you at less risk than someone having anal sex for an extended period of time, but the risk is still present.

The risk for infection per sexual contact (without condoms) with an infected person is pretty low, but it is still real. I'd recommend that you try using condoms with your partners in the future and get tested in about 3-6 months. It would also be advisable that you look at the specific antecedents to this unprotected episode and see if there are ways that you could modify them in the future.

RMK



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