Risk to top? is PEP warranted?

[livingloving]

Hi all,

I am male top and hiv- 30 and uncut and DDF and met a male bottom on a dating site. The guy listed himself as negative.We met up at a bar and then he came home with me. I used condoms during the anal sex. Me top, him bottom. However somewhere along the way the condom slipped off either when i was gonna remove myself from him or maybe it slipped off a 1-2 minutes prior. I checked the condom a few times while i was inside and it rolled up and i kept rolling it back down. When i removed myself at last I saw the condom was missing i informed him i was negative and then he confesses and say he is positive.

The information I gathered from another source suggests that the majority cases of condom slippage or breakage do not result in HIV transmission and rather unprotected safe from start to finish was the main reason of transmission. However this information is from 2001 and PEP was almost never recommended in a case like my own. In recent HIV material PEP is almost always suggested/recommended

The guy informed me he's been positive for 10 years and undetectable. Today I cringed thinking about this situation because i was recently tested neg and that was suppose to be a new start of sorts but i'm trying not to be to upset about this as i know i was too responsible and i was being responsible by using condoms up until the slippage.

Do you think i should get PEP? I do not have health insurance and i'm not sure how my body will take to this medication (i have a heart condition) and frankly i'm scared. the guy told me he chooses not to put his information online but insist on safe sex. he said he would be around if i needed to talk about it. He also said he understands my anxiety but feel i will be ok given this brief encounter. however, he's not a doctor.

what do you think? Please advise. I don't want to PEP if this is not considered significant. Furthermore I think i am now out of the window period.

please help. please.

[jkinatl2]

Personally I would not think PEP is warranted in your case. Your risk was small, though not zero.

A person on meds and undetectable is of almost no risk to you even if you don't use a condom.  Far more dangerous are people who do not know their status, and who do not get tested because otherwise they would not feel comfortable claiming to be "DDF" on "dating" sites.

However, please, I beg you, assume all your partners are positive regardless of what they say, until such time as you are in a securely monogamous relationship with an HIV negative person.

[livingloving]

Thank you very much. I really appreciate it. I don't agree with the way things went but I do understand him for holding back this information online. I do practice safe sex and will continue to do so. Again, I really appreciate your feedback.

much love.

[Ann]

Living,

I agree with Jonathan - PEP is unwarranted in your case. In addition to the reasons he discussed, hiv is a fragile, difficult to transmit virus, particularly from the receptive partner (bottom) to the insertive partner (top).

It sounds as though your condom came off as you withdrew. This is a common occurrence when you do not hang on to the base of the condom when you pull out.

And please take what Jonathan said to heart - you need to always assume the other person is hiv positive, regardless of what they may tell you. Sometimes people lie (out of fear of rejection) and sometimes people only think they are hiv negative.

The earliest you should test is at six weeks, as the vast majority of people will seroconvert and test positive by this time, with the average time to seroconversion being only 22 days. A six week negative must be confirmed at the three month point, but is highly unlikely to change.

Good luck; I fully expect you to test negative over this brief, possible exposure.


Here's what you need to know in order to avoid hiv infection:

You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI. Sex without a condom lasts only a matter of minutes, but hiv is forever.

Have a look through the condom and lube links in my signature line so you can use condoms with confidence.
Anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than hiv.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid hiv infection. It really is that simple!

Ann

[livingloving]

Hi Ann,

Thank you very much for your reply. I honestly can't be sure when the condom came off however i do know i checked it a few times during the sexual act and if it came off it was not for longer than 1-2 minutes.

I really appreciate your feedback and I do plan on practicing safer sex until I meet a partner and we feel comfortable enough with each other to do otherwise.

Thanks so much.

[Ann]

Living,

You're welcome. Your commitment to condom use is commendable. If  you're also having regular sexual health check-ups, you should be fine where hiv is concerned.

For future reference, the window period for initiating PEP is 72 hours, but it is recommended you start within the first 36 hours. You would mainly want to consider PEP if you are the bottom partner and someone cums in you without a condom ( due to breakage or whatever).

Ann

[livingloving]

Thank you. I will be sure to pass this valuable PEP  information along to friends that may need it as well.