Unprotected anal as the bottom?

Question

Thank you all so much for the information you out out on here!!! Had a possible exposure a few weeks back and researching tirelessly and there is so much info out there but also so much noise that it is very confusing!!! I was the bottom for unprotective anal sex with someone I had just met. I thought he was using a condom, but never checked and learned obviously that he didn't. We had sex for about 6 or 7 minutes, he eventually pulled out of me and after another few minutes he ejaculated on my body. I did not notice any blood. He used lube. Anyway I freaked out and went to the hospital and started PEP at 21 hours. He says that he is clean but I obviously don't trust him. I was able to get him to take an HIV test (oraquick rapid antibody blood prick) 2 days after and he showed negative. Of course I have read so much on the window period and how HIV transmission is higher during this time. So in summary, I was the bottom for unprotected anal sex, he ejaculated outside my body, I started PEP at 21 hours, and he tested negative on antibody 2 days after the event. I also took an aptima HIV RNA qualitative TMA at 12 days post exposure and it said undetected. But then I have been told that this test doesn't mean anything, but also have been told that it does mean something. Just looking for some thoughts on how high you think my risk is?? And also thoughts on if PEP affects the aptima qualitative RNA.

Thanks again for all your work!

Answer

Thank you for writing in with a serious question about a sexual event that has been troubling you, and trusting us here at The Body with valuable information. It is certainly my goal to help people learn the medical facts and science that can best help guide people toward more relaxing, empowering, and meaningful sexual encounters.

Based on the circumstances you describe, I just can't see any risk going on. The only potentially murky area is what happened during those 6 or 7 minutes he was inside you without a condom. But then you clarified he ejaculated outside your body, which put any question of HIV exposure to rest.

I know some people may postulate that there could have been a risk from his precum during those 6 to 7 minutes. But we have no research nor data to prove that HIV can be transmitted through precum by itself. So even if your partner did have a detectable and transmittable HIV load, he still could not have transmitted it to you through 6 or 7 minutes of sex without ejaculation.

In addition to all that, you started PEP right away. I would not have recommended PEP medically in this situation, but it can be used as well for peace for mind as it seemed to do here. So the fact you were being proactive about this incident, that contained no real HIV risk, can certainly help you to feel calm and in control.

And if all that wasn't enough -- Your partner tested HIV negative on antibody test, and you tested negative on an RNA test. Seems to me you have all the bases covered: Your HIV negative partner could not have transmitted HIV to you by fucking you for 7 minutes without ejaculation. It just didn't happen.

Now, if you're like me and more than 465,000 people in the world, who enjoy have condomless sexual experiences without the risk of acquiring HIV, then I would suggest you consider PrEP as an option. It allows us to have these kinds of experiences with or without ejaculation, knowing the HIV status partner or not, and still not get HIV. To learn more about the power of PrEP please visit our resource page here at The Body: http://www.thebody.com/index/treat/tenofovir_prevention.html and/or my Facebook "PrEP Facts" group at https://www.facebook.com/groups/PrEPFacts.

I hope the facts here help you to relax, and make any future decisions based in knowledge, confidence, and pleasure. Enjoy!