[Question #8913] Confused about hiv
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38 months ago
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Hello,
I was browsing through the answered question and I am confused with the given answers about hiv. I read here that hiv can’t pass through a condom. Only approximately once a month I engage in receptive anal sex ,choose my partners carefully and ask about them status (which is not foolproof I know). But then I also read that even condom protected is low risk for hiv even if a condom doesn’t break. I never had a condom broken and even for oral sex I use a condom. I always use condom with lubricant.
I read condom protected sex is safe sex but for receptive anal condom protected is low risk. Also that hiv is hard to catch but after 1 unprotected event it is a risk especially between msm. Because Feb 14th,April 2nd I had , May 10th, May 16th and yesterday I used condom but no broken condom at all. My last hiv and syfilis test was from Jan 15th and came back both negative. My partners have sex with other men but they use condoms for anal sex but not for oral sex. Should I be worried and get tested because I am very confused.
Kind regards
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H. Hunter Handsfield, MD
38 months ago
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Welcome back, but it should not have been unnecessary. In your several previous threads, Dr. Hook and I have both given you all the facts and data you need to remain sexually safe at no significant risk of HIV. Here is what I wrote in one of your previous threads; it was intended to shut down further questions that go into more detail than necessary:
Your several questions indicate you are overly worried about minor details of potential HIV exposure. For any males having sex with other men, the way to avoid HIV is to 1) ask about and know your partners' HIV status (avoiding most sex with those who don't know or evasive, or who are infected and not on effective treatment); 2) use condoms consistently for anal sex, both giving and receiving; and 3) use PEP or PrEP [in event of condom failure or other unsafe high risk exposure].... That's pretty much it. Other sexual practices -- fingering, getting infected fluids (e.g. semen) on the skin or even on the anus or in the mouth -- carry no additional risk beyond what you already experience with condom protected sex."
There is no conflict or reason for confusion about condoms. People who rely on condoms have over 90% reduction in HIV risk; the more careful and consistent the use, the closer to 100% it becomes. Among people who SAY they use condoms correctly 100% of the time do not have 100% HIV risk reduction. However, the reason probably has nothing to do with leakage through condom pores or microscopic leaks. It's because a) some people lie, b) others had unprotected exposures they don't remember (e.g. drugs, alcohol, etc), c) some also have regular partners they consider safe and don't use condoms, where in fact those partners are infected, d) had unrecognized condom breakage, etc, etc. In other words, human error. This is why even careful and consistent condom users should be tested for HIV from time to time, even if there have been no apparent condom failures etc. As for your partners having unprotected oral sex, that means they are at low risk for HIV, but here too you can never be 100% certain.
You are doing everything you can to prevent HIV, and the chance you will ever catch it is low. But it isn't zero, and you cannot make it zero risk unless you decide to never have direct sexual contact with other men. I do not recommend that. You need not be tested after every new contact. A far better approach, assuming you are following these safety measures and there is no obvious condom failure, is to just be tested once or twice a year.
As you have been informed previously, repeated questions on the same topic are strongly discouraged. ASHA does not wish to collect posting fees to give the same answers repeatedly, and such questions have little educational value for other users, one of the forum's main purposes. Having had several such questions. You should not need reassurance from us every time you have a new sexual experience with a new or potentially infected partner. Just keep in mind and rely on my statement above. Any further questions along these lines are subject to being deleted without reply, and without refund of the posting fee. I'll answer one or two BRIEF comments or clarifications, but once this thread is closed, it's your last along these lines. OK?
HHH, MD
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38 months ago
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Hello,
Thank you for giving comment instead of schutting me down. Sorry for another post which seems unnecessary to you. I cannot control my sexpartners and I wouldn't want too and that is a risk yes. So therefore I am so consistent in condom use. The confusion is: I always check afterwards if the condom is still intact so I am safe I think but the recommendation is to test 1 or 2 a year because an intact condom can't pass hiv and I was confused that you and Dr Hook meant that even with an intact condom hiv infection is still possible. But you mean human error about condom use and not potential risk if the condom does not break. Right? English is not my native language, so I apologize if my sentences are not coherent.
If I can't return, which I understand of course I would like to use the opportunity to thank you and Dr Hook for the comments given.
Bye
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H. Hunter Handsfield, MD
38 months ago
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I explained why you should still be tested despite correct and consistent condom use without visible condom breakage. It's just common sense for all people in such situations to be tested. And the periodic negative results should be reassuring.
Thanks for the thanks. We are glad to have helped. But please do your best to understand -- if unclear because of your English skills, ask a friend to help or use Google translate. And once you're sure you understand everything we have said, to believe it!
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38 months ago
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Hello,
I need one more clarification please. If I decide to test for hiv tomorrow, will that be conclusive if my last encounter was 3 days ago (it was only anal condom protected receptive nothing more)? Or should I wait 6 weeks? If I only should test 1 or 2 times a year, should I wait 6 weeks after an encounter ? I think you assume my test will be negative but you recommended testing to keep the finger on the pulse regarding human error.
I understand English Dr, it is my sentence structure what I think my sentences don’t seem coherent because I translate from my language directly to English :).
Thank you
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H. Hunter Handsfield, MD
38 months ago
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No HIV test becomes positive sooner than 7-10 days; a negative result at 3 days is meaningless.
In event of a known high risk exposure (e.g. condom rupture with an HIV infected partner), I would recommend RNA testing at 10-14 days and, if that is negative, an AgAb test at 4 weeks. That negative combination would be conclusive. By itself, the AgAb tests are conclusive at 6 weeks. Therefore, if you continue your current sexual lifestyle and test once or twice a year, I would recommend you do so 6+ weeks after the most recent sexual contact.
"I think you assume my test will be negative but you recommended testing to keep the finger on the pulse regarding human error." Exactly right!
That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been useful. Best wishes and stay safe.
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