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Over-vigilant Anal Sex
Feb 14, 2010

Hi Dr.

So I am typically very safe and always wear a condom before anal sex. (Top guy here) But last night, I made the lapse in judgment of putting inserting one time into my partner forgetting that i had no condom on. It was a really heated and intense encounter - guess even uber vigilant safer sex guys like me can get caught off guard when the sex is too intense. After realizing what had happened, I pulled out right away and inserted my condom on and then proceeded anal sex..safely.

What is the risk for a 'single' insertion into a partner of unknown status (he says he's negative, but who's to know these days)?

Thank you

A.

unknown

Response from Dr. Frascino

Hello A,

Yes, even "uber vigilant safer sex guys like (you) can get caught off guard when the sex is too intense." The archives are filled with many such uber-vigilants, proving once again that the higher powers gave man both a penis and a brain, but only enough blood to run one at a time.

We really don't have estimated-risk statistics for a single thrust, just as we don't have exact statistics for 100 thrusts or missionary versus reverse cowboy positions etc. The best I can offer is to confirm you did have a lapse in judgment that put you at some degree of risk for STDs, including HIV. Consequently, you'll need an HIV-antibody test at the three-month mark, no matter what the statistical estimate might be if we could predict it! It really is that straightforward. If someone has put themselves at risk, he needs to be tested. Period.

I can advise you the CDC's estimated per-act risk statistic (relative risk, not actual risk) for insertive anal sex is 6.5 per 10,000 exposures to an infected partner. Your risk would obviously be less, as we don't know the status of your bottom boy and your unprotected exposure was brief.

Hope that helps. Good luck with your test.

Dr. Bob



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