[Question #13847] Unprotected anal sex

1 months ago

So about 3 weeks ago I had unprotected anal sex (I topped) with a transexual I met on grindr. I ejaculated inside or her. She told me she was clean. I have no symptoms. Do you think I need to be tested? What are the chances of contracting and sti from this one exposure?

1 months ago

Forgot to mention she said she is on doxypep.

H. Hunter Handsfield, MD

1 months ago

Welcome to the forum. Thank you for your confidence in our services.

You don't provide enough information on your partner to judge her risk of having HIV or other STIs -- sexual lifestyle (sex worker for example)? Multiple partners? Someone you knew socially or only for sex? But even if she is very sexually active or a sex worker, most people don't lie about infection status when asked directly -- that is, her statement she is "clean" most likely is true. In addition, that she uses doxy-PEP indicates she cares about her health and takes steps to protect it.

On the other hand, she apparently allows unprotected anal sex and you made the unfortunate decision to not use a condom. This obviously raises the risk somewhat. Nevertheless, it remains unlikely you were infected with anything. Hhaving no symptoms after three weeks also is reassuring.

Testing in this situation is optional. Honestly, if somehow I were in your situation, I would not feel a need to be tested. But you might be further reassured by negative test results. If so, I would advise a urine gonorrhea/chlamydia test and, 6 weeks after the exposure, blood tests for HIV and syphilis. If you decide on testing, you can be confident the results will be negative.

I hope this will be a learning experience for you in regard to condoms. Please keep them handy and use them for any future events of this kind.

Let me know if you have any further questions. Best wishes-- HHH, MD

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1 months ago

Unfortunately I don't know much about this person. She stated that she used condoms, was on prep and uses doxypep. I assumed she would have condoms when I arrived, but did not. In a moment of weakness I went forward with the encounter anyway. Dumb. I am going to be tested for peace of mind today. Ehat are the chances if c contracting something from a one time sexual experience, topping, from someone who is on doxy and prep, assuming she probably has many sexual partners. Thanks.

H. Hunter Handsfield, MD

1 months ago

Most single anal or vaginal sex encounters result in no infection, even if the bottom partner is infected -- although it varies a lot between infections. IF your anal partner were infected and not on treatment, best estimates of your risk: HIV under 1 in 1,000; gonorrhea 50%; chlamydia unknown, maybe as high as 25%; syphilis (if she had primary or secondary infection) probably somewhere around 10%; HSV2 maybe 1 in several hundred to a thousand. In your case, since people usually don't lie when asked directly about health status etc, with "usual" condom use and on PrEP and doxy-PEP, there is very little chance she has HIV, gonorrhea, chlamydia, or syphilis -- which is why I said testing is optional and not something I would consider mandatory.---

1 months ago

So today is 4 weeks from the encounter. I have sinus congestion and feel like I might be getting sick. No fever or aches. Just feels like a head cold. Could this be ars? Would you still say testing is optional?

H. Hunter Handsfield, MD

1 months ago

ARS does not cause nasal congestion or cough and 4 weeks is too late for onset of ARS. You caught a cold. Testing for HIV remains optional.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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