Bottomed with someone who is on PrEP
Dec 15, 2017
Just giving some back story. I am a gay man. I recently just had unprotected sex with a old FWB. He is on PrEP and tested about 3 months ago. I was the bottom. He was in me for about 5 mins and he didnt ejaculate in me. I was reading quite a few posts and start to get worried. My thoughts are or a few people suggested that if he is on PrEP ( which he may or may not take the pills on time) therefore, he may have unprotected sex all the time and get affected. It is easier to pass it to other people at the beginning. Therefore, I might get affected too. I am wondering whats the chance? I will get tested soon as well. So I know.
Response from Mr. Jacobs
Thank you for writing in with your concern. It is a question I receive often, so it's worth going into with some detail.
Pre-Exposure Prophylaxis (PrEP) is a drug that prevents an individual from acquiring HIV if they are exposed to detectable viral levels. If used as prescribed, it is over 99% effective (http://www.natap.org/2016/ICAAC/ICAAC_02.htm). In the initial efficacy trials, no one who used PrEP four or more times per week acquired HIV (https://www.robertmgrant.org/project/has-prep-ever-failed/).
So if your partner was using PrEP as prescribed, which includes getting tested for HIV every 3 months, then his chances of having HIV are nearly zero. If someone does not have HIV, then they cannot transmit HIV to others.
However, as you duly noted, none of this information does much for your worry. And that's exactly the point: YOU are 100% responsible for your own protection, not your partner. It is not your partner's duty to assure you that you are HIV negative. He can try, and already has. But you won't experience his reassurances as helpful, comforting, or truthful, unless you are getting tested regularly and consider using PrEP for yourself.
Now, let's just say for the sake of argument that he was HIV positive, not on meds, and had a detectable viral load without knowing it. Even then there would not be significant risk with the events you are describing. He was inside you for five minutes and did not ejaculate. Although there are medical theories that suppose that precum can contain HIV if the person is HIV positive and detectable, there are no real world studies or experiences that have ever shown this to be a reality. After 36 years of research, we understand a lot about HIV is transmitted. The fact that there are no examples of precum as a credible variable in over 70 million transmissions tells you a lot.
One more clarification: You mention you had "unprotected" sex with a friend. But in fact, PrEP is one of the most protected kinds of sex that one can have. The efficacy of consistent PrEP use (99%+) far outweighs a condoms-only approach which at best is estimated at about 70% effective (https://www.aidsmap.com/CDC-researchers-publish-estimate-of-effectiveness-of-condom-use-in-anal-sex/page/2930716/). I say "estimated" because there is very sparse research that tells us how well condoms prevent HIV transmissions, whereas with PrEP there is an abundance (see earlier citations above). In other words, you had VERY protected sex with your friend.
If you are interested in finding PrEP in the U.S., check out the national database of providers at https://preplocator.org/ .
For providers outside the U.S., check out the global database here: https://www.pleaseprepme.global/ .
To join in discussions about PrEP, pleasure, connection, and research, please join the Facebook "PrEP Facts" group at https://www.facebook.com/groups/PrEPFacts/ .
I hope this helps you to relax, and figure out what decisions you need to make in order to experience the kind of protection and pleasure you prefer.
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