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Anal sex, HIV positive and PEP?

Oct 27, 2018

Hello Damon,

Thank you very much for answers our questions. I, too have a question that I want to ask you:

I have had protective insertive anal sex and received unprotected oral sex on two separate occasions with a HIV-positive guy about 2 months ago. Note: He told me that he was positive only after our second sexual contact and within 48 hours of that I was put on PEP.

A few days after I finished taking PEP, I received a 4th gen antiboday&P24 Duo test, and was told negative.

Can I relax now?

Thank you very much

Response from Mr. Jacobs

Thank YOU very much for reading this column and trusting The Body as a resource of information and support.

So based on what you are asking, I think you could have relaxed from the beginning if you had been given the correct facts.

The events you describe present no actual risk for HIV transmission. The reasons for that are:

(1) You state you had protected sex as the top. Even without protection, the possibility of you acquiring HIV as a top is less than 1%, and diminished even more if you are circumcised (https://www.poz.com/article/HIV-risk-25382-5829).

(2) You cannot acquire HIV from receiving oral sex.

(3) You don't mention if your partner was on HIV treatment medications but if so he is likely undetectable. If someone living with HIV is undetectable for six months or longer, they cannot transmit HIV sexually to other humans (http://www.thebody.com/content/80813/hiv-undetectable--untransmittable-uu-fact-sheet.html). Even before six months have gone by, it is still very unlikely that they can transmit HIV to others.

Under these circumstances, many medical professionals would not have prescribed PEP, given no risk is present. But, yours did, and life goes on. But could you have acquired HIV from these two encounters? No. Can you relax? That is entirely up to you.

If you continue to fear acquiring HIV, you may want to consider using PrEP for HIV protection, as that is medication regimen that puts you in control of your own protection regardless of your partner's HIV status, regardless of whether condoms are used or not. PrEP is considered more than 99% effective at preventing HIV transmissions (http://www.thebody.com/content/80972/has-anyone-gotten-hiv-when-they-were-on-prep.html). Feel free as well to view our resource page here at The Body to learn more: http://www.thebody.com/index/treat/tenofovir_prevention.html

Unfortunately, most gay and bisexual men have only been taught how to fear sex and anticipate catastrophic outcomes. But with these facts I hope you can allow yourself to enjoy the pleasure, play, and empowerment that sex can offer and that you and your partners deserve.



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