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Oh Manila, Dangerous place to be gay
Dec 23, 2010

Dr. Bob, I am an Idiot!!!

This is the story, I am married but I have discovered I am at least Bisexual. For the last three years I have secretly engaged in safer sex practices with high risk groups. MSM and TGs (Which in the way are the same thing) who have sex for money. All my action typically happens in the PhIllipines. All of it, until two days ago is safer. Two days ago I met a ladyboy in Manila. I went with her (or him) back to the hotel.

All my rules were enforced until she forced a condom on me and sat on my 7 inches of pink steel (I wasnt completly forced lol) Anyway she rode i for about 3 minutes before I snapped back to my senses and made him get up. I remembered when he put the condom on me he bit the end(dunno why). I immedialtly went and washed myself then asked the poor guy over and over what his status was.

He said he was clean and that he was processing paperwork to go to Italy. I told him I would gladly pay him to see that paperwork. He took me to his shack, I mean this place is a poverty I had no idea even existed. He shares the shack with another person. My loveley escort for the evening sent the roommate to go get the medical papers. He returned 10 minutes later, not with papers but with a small baggy of shebu. Its like filipino crack. I said ok, you smoke that but afterwards we are going to the hospital to get a test. The ladyboy said fine but pay me. I agreed. We went.

The hospital refused to test us because no consoler was on shift. I said I had an exposure and was unsure of my partners status and asked if PEP was warranted. The medical staff Said "whats Pep, no Hiv test till monday." Craziness, my Ladyboy friend demanded his money I paid him then he gave me a bad phone number (I probably wouldnt want a follow up date with me eithier!!!)

As far as the PEP goes, I read that in a low prevalance setting, under 15% for a selected group, that Pep is not recommended for the top in anal sex. You agree with that? If so I am not mad at the hospital.

I have noticed a cycle with me, it goes incident of gay sex, panic, riskier behavior based on the fact that I already had a incident then testing. I cant live like this. I am going to tell my wife after the holidays what happened and about my sexuaity.

As far as my exposure I have 1 in 1538 chance of contracting the virus based on unprotected insertive anal sex (I was the Top). My odds are probably a little higher becuase the condom never broke It just had a hole in it from my crazy ladyboy friend. I shaved me boyparts a few days before but had no open scar the skin was intact.

Is my risk assessment right and in the worst case scenario am I ok to hang out at the house as long as I have no sex with my wife? I think the answer is yes but I dunno for sure. As soon as the holidays are over I will tell Her everything and probably be single. I just dont want to put her at risk. As long as we have no sex and exchange no blood, like from popping each other pimples or whatever we should be ok right?

Thanks Dr. Bob for all your help and know you have my prayers. I hope they find a cure soon, such a cruel disease.

Merry Christmas

Response from Dr. Frascino

Hello,

Scary and all-too-common story of closeted sex leading to a crisis situation. I'm delighted you've decided to level with your wife and to be more honest regarding your sexual orientation. Closets are health hazards!

I'm shocked at the hospital's refusal to perform an HIV test! Shameful, totally unjustifiable, and quite dangerous in my opinion.

Regarding the PEP recommendation, I don't agree. If you had unprotected insertive anal sex (or condom failure) with a partner confirmed (or highly likely) to be HIV infected, PEP would be warranted, even in low-prevalence settings. Remember, you were shagging a destitute transgendered shebu (crack) smoking sex worker! The HIV incidence for this guy/gal may well be higher than the low prevalence associated with the country.

Regarding being in your home, there is absolutely no risk to your wife or anyone else, unless you have unsafe sex with them or they come into contact with your fresh blood. HIV is not transmitted via casual contact.

I would recommend you have HIV tests at both the three- and six-month marks. Psychotherapy (counseling) may also help you break the cycle of your self-destructive behavior and address sexual-orientation issues.

Good luck.

Dr. Bob



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