[Question #13271] HIV transmission risk, I'm a top, no condom, saliva as lube, penile adhesion
27 days ago
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What is my risk please? To help me decided whether or not I should get on PEP.
I just made a stupid mistake 1 hour ago. I had anal sex with no condom.
I am top and circumcised BUT I have a penile adhesion.
And unfortunately I used saliva as lube (mistake, i know, because it increases likelihood of tearing, compared to normal lube). Not sure whether or not the saliva dried up; my penis was inserted for about 5 or 6 mins.
I have no idea whether the other guy (bottom) is positive or not but he seemed very comfortable with having unprotected sex. I met him on Grindr.
Should i go get PEP? I am trying to assess my risk to make an informed decision. Also I am taking PRAXLOVID right now. I tested negative for covid today. But I have 2 days left on my Praxlovid prescription. So not sure if that is a factor on whether i should get on PEP.
Btw, I havent had anal sex in years. I normally only have oral sex.
Can you give me your thought regarding my risk (especially given my penile adhesion and use of saliva as lube) so I can decide whether PEP is needed?
THANKS!
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H. Hunter Handsfield, MD
27 days ago
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Welcome to the forum.
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We do not provide personal advice for or against PEP. Decisions about PEP must be made only by a local doctor or clinic familiar with HIV epidemiology and risks in that community.
Even if your partner has untreated HIV, your risk of catching it probably is roughly one chance in a thousand. But that's high enough to advise PEP if your own doctor or clinic advise it. If you are able to contact him and he agrees to have a new HIV test, if his result is negative you would have no worries.
However, your main concerns are entirely wrong. Your risk of HIV depends entirely on where you are, the nature of your partner, and the chance he has HIV. If he is a man who regularly has sex with other men in an area where HIV in MSM is common, your local doctor might advise PEP. Whether you are circumcised, used saliva as lubricant, and have a penile adhesion have absolutely no signficant effect. When you seek local care and advice, you can expect your doctor to agree these are unimportant. Whether or not you have COVID or are taking Paxlovid (or any other medications) also are irrelevant: they do not affect HIV risk.
I'll be happy to comment further if you would like to let me know how things go after you have sought personal care for a PEP decision. Best wishes and good luck.
HHH, MD
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