[Question #3437] Risks?

35 months ago
Hi,

I'm a 33 canadian male (recently single) and last night i (as my first time)  encounter a 40 old male (white from canada too, bisexual). I meet i'm online, he told me he got tested 2 month ago, but i cannot validate this. So he perform unprotected deepthroat on me for a minute. I give him a unprotected BJ for about a minute too. Then he give oral-anal to me for a minute (unprotected). After that i receive anal sex (protected) for 10 minutes and he finish with fingering a bit. 

Now, i'm really afraid for STD, and HIV in particular. I know its not a high risk encounter, but i'm still really nervous (even if im single) that i catch HIV and ruin the rest of my life for this. 

Question like what if the condom broke and i failed to notice or cut on his finger or risk from oral sex ETC ETC, my head keep spinning and i just want to know if i should get Post-exposure prophylaxis ASAP or if i should get tested in 4 weeks.

Thanks
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Greetings. Welcome to the forum. Thank you for your confidence in our services.

This can be considered a very safe exposure in regard to HIV. First, your partner is unlikely to have HIV. Most people don't lie about HIV status when asked directly. Of course you're in the best position to judge whether he seemed honest and non-evasive about it, but it sounds like he was being straightforward about it. Second, oral sex (in either direction) is low to zero risk for HIV -- slight risk for you performing unprotected oral on him, but even then the estimated average risk, if the penile partner is infected, is around 1 in 10,000. That's equivalent to giving BJs to infected men once daily for 27 years before transmission might be likely. Receiving oral is even lower risk -- in fact, there has never been a scientifically validated transmission. Fingering is no risk, regardless of cuts on the finger etc:  here too, there are no proved or even suspected cases of HIV transmission by fingering or other hand-genital contact.

So that leaves the receptive anal sex the only real concern, and that's really not a concern assuming the condom didn't break -- and most likely that would have been noticed by your partner, and probably by you as well.

So I would put the odds you acquired HIV at no higher than 1 chance in a million, and several million probably is more accurate. Accordingly, I defintely would recommend against PEP; the chance you were even exposed to HIV, let alone infected, is just too low. Also, there's an important downside to PEP for anxious persons:  if PEP fails, it may delay the time to conclusive testing, and experts recommend waiting 3 months or even 6 months. So your potentially anxious interval is markedly extended, compared with conclusive testing at 4-6 weeks without PEP.

In fact, the risk is low enough that I would not even recommend testing for HIV, at least not from a strictly medical or risk standpoint. However, you probably should be tested anyway:  most people in your situation will be more reassured by the negative test results than by advice based on probability and statistics, no matter how expert the source. If you find my reassurance settles things for you, that's great. But if you remain nervous, plan on an antigen-antibody ("combo", "4th generation") blood test in a few weeks. These tests are nearly conclusive (98-99%) at 4 weeks and 100% any time 6 or more weeks after exposure. If you choose to be tested, you definitely can expect a negative result.

I hopet his information is helpful. Let me know if anything isn't clear.

HHH, MD
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35 months ago
Thank for the quick reply.

I ask him again and he said that he got tested with is female fuckfriend at the time (2 months ago)... And she dump him and he got tested again (to get a clean start) and will get the result in  paper copy Wednesday and will send the photo to me.

But again, even if he lied and send me a fake photo of his testing and he got HIV, i should not lose sleep over this right ?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Exactly right:  even if he has HIV, you are at no significant risk.---