[Question #13711] Foolish mistake, similar fact pattern as a couple of years ago
 |
3 hours ago
|
Had a massage last night and it went further than expected. mutual oral, mutual anal briefly and unprotected. I ejaculated in them, they did not in me. Me being receptive lasted about 20-30 seconds. Me being insertive was several minutes with completion. Foolish on my part all the way around. I know how high the risk is. They claim (no reason to not believe them I know) to be on prep (the injection in the butt), and doxy as well and are regularly tested with their dr in seattle. They claim to have been recently tested. I am not on Prep because this isn't a regular thing but maybe I should be. I did immediately take 2 100mg doxy afterwards. My understanding is that will protect against syphylis and clamydia but not gonorrhea. Should I cefixmeme and azithromicin and take for the potential of gonnorhea? lesson learned that one should always have condoms on hand b/c things can evolve. I appreciate your insight as always.
 |
H. Hunter Handsfield, MD
1 hours ago
|
Welcome back. However, having had very similar exposures in the past, probably you have predicted my replies.
Since the exposure had a "similar fact pattern" as in at least one of your several previous questions, obviously the answers are the same. The only difference seems to be the duration of exposure; longer penetration obviously is more risky than a few seconds as you described last time. However, that your massage partner is on PrEP reduces any potential risk to near zero, as we discussed last time. So does being tested for HIV recently with a negative result. Obviously this depends on his truthfulness, but as we have discussed previously, potentially exposed partners rarely lie about their HIV/STI status.
Although you are correct in your understanding that doxycycline is not reliable against gonorrhea, it is not without effect: roughly 50% of gonorrhea strains are susceptible to it. In addition, if you acquire urethral gonorrhea from unprotected topping, you'll know it within 5 days because of symptoms and can seek prompt treatment at that time. We do not provide directly health are advice: both legally and practically we cannot practice medicine from this distance. But if personally if I were in your situation I would not take any antibiotics.
I agree with your "lesson learned" about condoms -- but you said the same thing previously. Maybe that conclusion will stick with you this time. As for you being on PrEP, that's a personal decision -- but if events like this are happening under once a year (in which case you're not asking us about other exposures), probably it isn't necessary. OTOH, PrEP "on demand" -- starting shortly before an expected exposure -- might be a consideration. It's not as reliable as continuous PrEP, but usually works. This might be something to discuss with your health care provider.
Finally, one more option is to discuss the situation and your concerns with your massage partner if you are able to be in touch. If you and he both were tested together for HIV and common STIs (gonorrhea, chlamydia, syhphilis) you would both know that neither of you could have exposed the other -- perhaps reassuring for both of you.
Let me know if anything isn't clear.
HHH, MD
--- |
1 hours ago
|
Thank you and your points are well taken. Given the activities and taking of doxy immediately should i still get tested for this event? (Outside of yearly testing)?
Doxy always makes my skin sensitive and weird tingling for a day or two after I take it. Of course that could be nerves.
Thank uou