[Question #5086] Seek your advice on STD test

23 months ago
Dear Doctor. I am asking for your comments on the below scenarios -  if test is necessary for screening HIV or other STDs.

It is about men who have sex with men and i received anal sex using condom.  it happened two weeks ago.  I asked him about health condition before started. He claimed himself to be healthy. I performed oral sex for him.  Then i received anal sex using condom. the condom was intact.  after few times' anal sex, he took out penis. i performed oral sex again and he ejaculated in my mouth.  

about half an hour before the sex, i found some blood around anus - because of tissue after toilet.  

my concern is what if the condom had his semen/pre-cum before he penetrated into anus.  this may happen if there was semen/pre-cum on his hand when he put on condom. or this may because he used the wrong side of condom and then when he changed, the top of condom may contain some semen/pre-cum.  

oral sex with ejaculation. i didnt have gum problems or bleeding.  but semen contact the mucous in the mouth. 

given the scenarios above, i hope to learn your recommendations on test for HIV and other STDs. Can i still have sex with my partner? if so, any special prevention needed?

Many thanks.




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
Welcome to the forum. Thanks for your confidence in our services.

My first reaction is to congratulate you on having safe sex. Not only was a condom used, but you and your partner discussed health status before having sex together. That's an important and often ignored part of sexual safety, especually for men having sex with other men. People rarely lie about HIV or STD status when asked directly, so probably your partner does not have HIV.

EVen if he had HIV, this was a safe exposure. As you probably realize, the blood undoubtedly was your own. Condoms do not leak -- so if it did not obviously break wide open, you can assume protection was complete during anal sex. Performing oral sex is also very safe -- not completely free of HIV risk, but one estimate is that if the penile partner has HIV, the chance of transmission is 1 in 10,000. That's equivalent to performing oral sex on infected men, with ejaculation in the mouth, once daily for 27 years before transmission might be likely. And your risk was a lot lower than that, because it is unlikely youar partner has HIV.

That said, there may have been risk of oral gonorrhea or, in theory, syphilis, herpes due to HSV2, and perhaps others. Still, the overall risk is low.

The quickest way to sort all this out would be for both you and your partner to be tested now for common STDs (gonorrhea, chlamydia, HIV, syphilis). In your case, this could also include a throat swab for gonorrhea testing. If those tests are negative, you'll know you were not exposed. If you cannot contact your partner or if he declines HIV/STD testing, you can be accurately tested yourself for gonorrhea and chlamydia (including throat swab) after 4-5 days; and for syphilis and HIV after 6 weeks.

Should you continue sex with your regular partner? That's up to you. The risk of any infection is low enough that I really don't think you need to do that. If somehow I were in your situation, I would continue unprotected sex with my wife with no worry at all. But I cannot give a 100% guarantee; if you feel you need absolute certainty, and if your recent partner isn't tested and negative, you'll need to avoid sex with your regular partner until all your own tests are negative.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
---
23 months ago
Thank you Doctor for the informative reply. 
yes, the condom was intact and did not leak. Since i noticed the blood around the anus skin or mucous, before meeting the sex partner,  i thought the the skin and mucous around anus was more vulnerable.  if the condom has his precum before penetrative sex (precum on top of condom from hands or due to incorrect use condom), will this enhance the chances of being exposed to STD and HIV? 
Again many thanks for the test recommendations. They are very comprehensive and clear.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
23 months ago
"What if" scenarios rarely are helpful in sorting out actual risk. Of course I can imagine that if pre-ejaculate fluid were on the outside of the contom, you could have caught HIV. However, there must have been billions of events in which there was such contact with pre-ejaculate fluid, in the presence of anal irritation, or bleeding caused by the sex itself. And yet we know of virtually no specific instances in which HIV was acquired during condom protected anal sex, if the condom did not rupture. So any risk was very low. 

Therefore, these considerations make no difference in my opinions or advice as noted above. Thanks for your thanks about it!
---