[Question #13516] Recent exposure
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1 months ago
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I apologize to be back here asking another question, maybe I am starting to ask out of anxiety. I made a mistake, and went back to a previously seen trans csw. was the top for condom protected anal. There was some mutual masturbation, but I don’t recall much of any other sexual contact, giving anal seemed to be the main thing. I am trying to convince myself that I don’t need pep. It seems harsh on organs, and probably unwarranted. I stress some because usually I came in condom so I could see it wasn’t broken. But this time, I pulled out, she removed the condom and I manually finished so I can’t confirm the condom state. given this exposure and frequency that this has happened, should I worry? Should I take pep, I spoke to a Dr that would recommend it, but it just seems that might be anxiety driven. As of a few weeks ago I did test negative for hiv, gon/chlam.
I have a wife and kids, so I’m depressed that I end up here all over again.
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1 months ago
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sorry, meant to say “a Dr that prescribed it, but it just seems that might be anxiety driven.”
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Edward W. Hook M.D.
1 months ago
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I'm saddened to see you back with rather repetitive questions. The encounter that you describe is virtually no risk. I would not recommend PEP for this exposure. Let me explain why-
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1. This is a partner you have been with in the past. She indicated she did not have HIV or other STI - that is unlikely to have changed. As Dr. Handfield previously explained, most people tell the truth. It is unlikely she has HIV.
2. IF she had HIV (unlikely) your risk of acquiring HIV from unprotected insertive anal intercourse is less that 1 infection in 1000. Thus IF she was infected there is a 99,9% likelihood you WOULD NOT be infected.
3. Condoms work and condom failure is obvious- condoms reduce your risk for HIV at least 90%, thus that make your likelihood of NOT being infected more than 99.99%.
4. Receipt of masturbation is a no risk event
5. IF your anxiety drives you to test, taking PEP would delay your ability to test accurately more than a month.
Please don't worry. You need to move forward without concern. EWH
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1 months ago
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Thank you Dr Hook. I understand enough regarding pep, that was the clarity I was hoping for. One other thing about this meeting that I have concern over is that there was a point where the trans csw put lube on me and tried to top me with a condom on, meaning I was poked in my anal area but stopped it and basically held closed. Condom was on and there wasn’t any real penetration, but rough poking in my anal area I’m not sure anything got in but it wouldn’t be significant. could this spread any std such as syphillis, HSV, trich, or clam/gon?
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1 months ago
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sorry again for adding on, but in this case if I were to have chlam/gon or syph in anal area from this described exposure, could it be spread from my penis to a female partner?
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Edward W. Hook M.D.
1 months ago
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You’re clearly anxious about the encounter you describe, but there is no reason to be concerned. As you pointed out, the condom was in place and condoms work. In addition, if there had been penetration, you would know it. This was a no risk encounter.
In response to the other part of your question, if you had an anal infection, you could not spread it through sexual contact with your penis.
Please don’t worry. EWH.
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1 months ago
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Hi Dr Hook, thank you for your reassurance. I originally was only concerned about when I topped, but now remember the received anal poking w/ condom.
1. I tested urine negative for gon/chlam and was trying to move on. Now I am concerned I got anal gon/chlam that could spread to other sights eventually if untreated. After the incident w/in 24 hours I took 800mg cefixime and then doxy 100x2 for 7 days. Would this be effective prevention against any syph/gon/chlam anal infections?
2. I don’t have a trusted source for anal swab, so if I had an infection at that sight what are the chances of it being non symptomatic and untreated, eventually spreading to a uro-infection that can transmit to a female partner?
3. If there was a direct aggressive poke that might’ve resulted in some tip/head penetration condom covered (I don’t recall), would that change your assessment?
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Edward W. Hook M.D.
1 months ago
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Expecting full responses is hindered by your failure to provide full information such as having taken antibiotics. Let's not play games!!!
1. Had you been exposed, the cefixime/doxycycline that you took would have prevented syphilis and chlamydia and reduced your risk for gonorrhea. Given that this was a virtually no risk encounter, neither you, nor future partners are at risk for infection.
2. Hard to imagine why you could not get an anal swab- more games? Irrespective had there been penetration, you would of known if. Still more partial information? If you did acquire anal gonorrhea or chlamydia many such infections are asymptomatic. If your encounter did not involve penetration, there is no risk- if there was penetration, between your antibiotics and statistics (it's unlikely your partner was infected and if they were, most exposures do not lead to infection, even without antibiotics. When considered along with the antibiotics you took, the likelyhood of infection is close to zero.
Rectal infections are NOT transmitted through penile-vaginal intercourse).
3. an "aggressive poke" without penetration would not transmit infection, IF your partner was infected.
This completes this thread. There will be no further responses. EWH
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