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Inadvertently Exposed !!! The Body: Rick Sowadsky M.S.P.H., C.D.S, Answers to Safe Sex Questions
Feb 6, 1997

I recently found myself in a position where I did not know my sexual partner very well and in a moment of passion my partner placed his saliva on his rectum and before I knew it my penis had partially slipped in. This occurred more than once. A couple weeks later I was still seeing this person and he had the honesty to tell me that he was indeed hiv positive. I am tested twice annually for this disease and am extremely concerned about this type of exposure. With all other STD's aside, I have been told that being the "top" person is low risk to hiv, barring any open sores, tears etc. Is this true? Although he claims to be in good health, shouldn't he be as concerned if not more for his health as well, since his immune system has been compromised by this disease?

Response from Mr. Sowadsky

Hi. Thank you for your question.

It is a common myth that the "top" person is at low risk for HIV and other Sexually Transmitted Diseases (STD's). In reality, they are at high risk for HIV/STD's, and the "bottom" person is at even higher risk.

When you have unprotected anal sex, you are at high risk for HIV and other Sexually Transmitted Diseases (STD's). The longer you were having unprotected sex, the greater your chances of infection there would be. Normally during anal sex, the insertive partner is exposed to the blood of the receptive partner. This normally happens because of the friction that normally occurs during anal sex. The more blood you are exposed to, the greater your risk for HIV there would be. There is also a significant chance for microscopic cuts and abrasions on the head of your penis, due to the friction that normally occurs during anal sex. These microscopic cuts and abrasions are too small for you to visually see, but large enough for HIV to enter your bloodstream. Since the head of the penis is made of mucous membranes, it is especially prone to these microscopic cuts and abrasion. Also, if you were to have any open lesions due to other Sexually Transmitted Diseases (STD's) such as herpes or syphilis, your risk increases, since this would give the HIV virus an easier access to your bloodstream.

The only way for you to know whether you became infected with HIV or not, is to be tested 6 months after this exposure. You should also consider being tested for other STD's including (but not limited to) Hepatitis B and syphilis. Testing is the only way to know if you became infected with these diseases or not. But the longer you had anal sex with your partner, the greater your risk would be.

It's important that we dispel the myth that the insertive partner during intercourse (vaginal or anal) is at low risk for HIV and other Sexually Transmitted Diseases (STD's). This simply isn't true. But we can say that the "top" person is at high risk for infection, and the "bottom" partner is at even higher risk (assuming the other partner is infected with HIV/STD's).

Your partner is indeed at continued risk for several reasons. If he gets re-exposed to HIV again, this can lead to problems down the line, including being exposed to another strain of HIV that may be drug resistant. He may also be exposed to other Sexually Transmitted Diseases (STD's) which can be much more serious, and harder to treat in those with HIV. So not only were you at risk, but so was your partner, if he has been having unprotected sex with other people with HIV or other STD's.

If you have any further questions, please feel free to contact the Centers for Disease Control at 1.800.232.4636 (Nationwide).



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