Hi doc,

I recently had receptive anal sex with an HIV positive guy. The anal sex was protected and to the best of my knowledge there was no condom failure. We also had oral sex - unprotected. My partner is undetectable due to arv treatment.

As far as I am aware this is low risk for HIV?

My worry is, before and after we had sex I gave myself a douche to clean out. I used my partners douche nozzle which I now realise was a mistake, he didn't use it before me and I don't think it had been used for a day or so. Prior to using it I smeared it with antiseptic gel and running water.

Is this a risk for HIV or hep c?

I've read that sharing sex toys and enemas are a significant risk for hep c . Am I now at significant risk for hep c?

I started pep to reduce my HIV anxiety but now my anxiety is fully focusing on hep c.

Truly terrified - please help

Kevin

Hello Kevin,

Assuming the latex condom was used properly and didn't fail (break) your HIV risk would be essentially extremely low (unprotected oral sex). That your partner is on effective antiretroviral treatment significantly lowers even further this already extremely low acquisition risk. Most HIV specialists would not strongly recommend PEP in this situation.

Your worries about hepatitis C are also unwarranted. While I agree you shouldn't share douche nozzles the chances you contracted hepatitis C from this incident are beyond remote. You don't mention your partner's hepatitis C status. Is he hepatitis C infected? If not, your risk drops to absolutely zero.

Good luck.

Dr. Bob