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Please assess my risk?
Apr 13, 2010

I plan on sending another donation! I need you help. This was my first gay experience and I am terrified. Here is the story: The guy I met rubbed his penis for a few minutes until erect, then placed a condom on. He rubbed my unprotected penis with his hand for about 4 to 5 strokes, and then began to rub the outside of my anus with his fingers for about 30 seconds. He then tried to penetrate my anus with his penis, but I stopped him at this point and left. The whole meeting lasted only a few minutes. There was no ejaculation or penetration (except I could feel the pressure on my anus). From what I saw, the condom was on him from beginning to end. I went straight to the bathroom and washed my member and anus with soap. Sorry for the graphic depiction, but I wanted you to get a full picture of potential exposure.

Assuming the guy was HIV positive 1. Since he massaged himself prior to putting on the condom, does this pose a risk if the outside of condom or his fingers were exposed to precum and then contacted the mucosa of my anus or urethra? Are my fears warranted?

2. Do any of the behaviors mentioned above require PEP? I started PEP anyway 48 hours post possible exposure (just in case) and plan to follow up with an ID soon.

3. Following this incident, I began to have diarrhea for two days (hopefully not an indicator of infection and just nerves). Once I started the tx. combivir/viread 300, the diarrhea increased ten fold then stopped. So far the medication is well tolerated. Do the side effects decrease once your body adjusts to the medication even though only a 28 day regimen was prescribed)?

Please advise, I would like your respected opinion prior to going to the ID specialist. Thank you so much for your time.

Response from Dr. Frascino

Hi,

I have no doubt your "terror" relates more to this being your first gay experience than to real HIV-transmission risk. If you had a somewhat similar experience with a woman, would you still be so terrified? Suppose she had been massaging her "home entertainment center" and then used the same hand to stimulate your back door? Chances are you'd be less worried, right? Yeah, I thought so. When it comes to HIV-transmission risk with someone of unknown HIV serostatus, it's not so much whom you have sex with but rather what activities you engage in. With that preamble, let's turn to your specific questions:

1. No and no.

2. No, absolutely not. I'd recommend you discontinue PEP. I'm confident all experienced HIV specialists would agree.

3. Your diarrhea is most likely linked to either anxiety or the potent antiretroviral drugs in your PEP regimen!

I'd suggest you spend some time reviewing the wealth of information on this site, in its archives and on the related links to learn more about exactly how HIV is and is not transmitted. We have entire chapters in the archives of this forum related to HIV sexual transmission, HIV sexual prevention and safer sexual techniques as well as other related topics. Check it out!

Finally, if you are having difficulty accepting (or enjoying) your sexual orientation, consider getting counseling. Sex is supposed to be fun, not anxiety provoking!

Good luck. Be well.

Dr. Bob



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