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Opinion on risk not asked much on this site.
Oct 26, 2009

Hello, Doctor, i asked this question recently but your response i think was mistakenly meant for another post.

I have read your answers in past months answering some of my questions from my participating in next to no risk situations and being paranoid. I really do apprecaite what you do on here.

Last night I had my first real scare where i was the receptive in anal sex with a guy who I did not believe was positive at the time, but later found from a friend could be positive based on his past actions.

We were participating in sex when his condom broke in me and he pulled himself out after about 10-15seconds. He later ejaculated inside me but did so inside another condom that did not break as he pulled out intact with the semen inside of it.

My question is do you think that am i have an extremely low risk for catching anything given the brief 10-15 seconds of him being inside me without ejaculation and very likely without pre-cum or any fluid at all, that there was little or no way that hiv could be transmitted from him if has positive?

Many thanks much appreciated!

Response from Dr. Frascino

Hi,

Sorry about that! Not sure what happened to the correct response to your question. Apparently cyber-poltergeists are at work early this Halloween! At any rate the correct response has now been restored. (See below.)

Dr. Bob

Opinion of non ejaculatory risk please Oct 25, 2009 Hello, Dr. I have read your answers in past months answering some of my questions from my participating in next to no risk situations and being paranoid. I really do apprecaite what you do on here. Last night I had my first real scare where i was the receptive in anal sex with a guy who I did not know was positive at the time, but later found from a friend heavily suspects is positive based on his past actions.

We were participating in sex when his condom broke in me and he pulled it out after about 10-15seconds. He later ejaculated inside me but did so inside another condom that did not break as he pulled out intact with the semen inside of it.

My question is is the risk of the brief 10-15 seconds of him being inside me without ejaculation and very likely without pre-cum or any fluid at all put me at much less risk then unprotected anal sex.

And do u think PEP treatment is necessary if he is confirmed to be positive considering this risk? (under 10 hours ago)

Many thanks much appreciated!

Response from Dr. Frascino

Hello,

Unprotected (or broken-condom) receptive anal sex carries the highest risk for sexual transmission of HIV. That your exposure was brief (10-15 seconds) and did not include unprotected ejaculation in the anal canal would decrease your risk somewhat, but certainly not eliminate it.

If your partner is confirmed to be "virally enhanced," PEP would be recommended if it could be started immediately (and no later than 72 hours from the time of the exposure). If your buddy's rapid HIV test is negative, PEP would not be indicated.

Good luck.

Dr. Bob



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