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Protected anal - shared towel
Jun 14, 2011

Doctor please help. I'm terrified. I'm a curious man and had an encounter with a transsexual CSW. We performed protected oral sex on each other. Then we did protected anal sex in which I was in the receptive position. This was my first time and it cause bleeding. After it was over, he removed his condom and whipped himself with a towel, then set the towel down. I got up and inadvertently picked up the towel and whipped the lube off my anus. We layed back down and talked a little bit. We then masturbated each other without protection. I then went to the bathroom and whipped my anus with toilet tissue and realized it was bleeding. I then though OH NO we used the same towel. I'm scared to death that I may have whipped fresh semen into a fresh cut.

The next day I was seen by a doctor at an urgent care center. I told him what happened. He said my risk of exposure was minimal and that I should not be as worried as I was. He didn't feel there was a need for PEP. But, he asked me call the person back and ask about his HIV status. I did and he said he was clean and gets tested all the time.

The next day I woke up and thought that my lymph nodes were swollen. I kept checking around my neck throughout the day. I checked my temperature that evening and it was 99.4 so I went to the ER. At the ER I was examined by young doctor. I told him what happened. He left and consulted a supervising doctor who came and spoke to me. He said based on what was told to him my risk was minuscule and he did not feel I needed PEP. Unfortunately, I'm experiencing extreem anxiety that semen from the towel may have gotten into cuts on my anus.

1. What do you feel my risk is? 2. How soon would I begin to experience symptoms? 3. How soon can I get tested (I'm told 3 weeks)? 4. Should I have gotten the PEP?

Thank you

Response from Dr. Frascino

Hello.

1. I agree with the assessment of the urgent care and ER doctors: Your HIV-acquisition risk is negligible.

2. HIV acute retroviral syndrome (ARS) symptoms generally manifest two to three weeks after primary infection.

3. HIV-antibody testing performed prior to the three-month mark is not considered definitive or conclusive.

4. Nope.

Your "extreem" anxiety is most likely exacerbated by guilt from your first encounter with a transexual CSW. I would suggest you get a single HIV-antibody test at the three-month mark. During the window period, counseling and anti-anxiety medications may be beneficial. I would also suggest you consider consulting a licensed mental health professional to delve into sexual orientation issues.

Good luck.

Dr. Bob



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