Brief dipping, bleeding bum

[ProfessorX]

Hello.

I'm sure I'm going to get flak for this, and think I know what the answer will be, but wanted to run it by this group.

I've been casual with this guy for about a month.  We get together maybe once a week for sex. 

We've been having sex with condoms if he penetrates me.  Yesterday, we did not have condoms.  We did engage in frottage, and he fingered my anus as well.  My anus was a bit sore yesterday morning, but it was feeling okay by the time we got together yesterday afternoon.

He did end up dipping his head in my anus for about, if less than, five seconds.  I had pulled away...as much as I wanted to continue, I knew I shouldn't, so didn't.  He precums quite a bit.

Later last night, I was in the bathroom, and noticed blood on the toilet paper. 

We've talked about whether or not we are "clean", and he's stated twice before that he is, once just before sex and once after another time.  He's a nice enough guy, and I do fairly trust him, but I can't help but think what if he's poz and just doesn't know?

Am I panicking too much?  Or would you feel that PEP is warranted in this case?

Thank you much for your thoughts.

And no, I don't think I'm going to let the "heat of the moment" cloud my thinking again...it's just not worth the concern. 

[Ann]

Prof,

The only thing I'm going to give you flak for is your insulting use of the word "clean". (We've talked about whether or not we are "clean") So you talked about how often you shower? Using the word "clean" to describe anyone's hiv or sexual health status is insulting to those of us who are poz. I'm poz, and I'm not "dirty", thank you very much. Please don't use that term here or anywhere else again.

Given the brevity of the dipping incident, I'd say your risk is very much on the low end of the scale and not one you should get PEP over. You would, however, be wise to test. It doesn't really sound as though you're in the habit of regular testing.

The earliest you should test is at six weeks. The vast majority of people who have actually been infected will seroconvert and test positive by six weeks, 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.

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 (twice is better) 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. Some of the other STIs can be present with no obvious symptoms, so the only way to know for sure is to test.

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

Ann

[ProfessorX]

Ann:

My deepest, sincerest apologies for any offending which was not meant.  I appreciate you pointing it out the proper verbiage to me.  I guess I was trying make my friend comfortable when I asked him as I always treat is as a rather delicate subject.  And I won't make that mistake again.

And finally, thank you for your timely response.  It puts my mind at ease quite a bit getting your feedback.   

[ProfessorX]

Ann - Sorry, one last thought.  I'm only asking as for a fair portion of the night thinking about it (Which I guess is normal).  Even with the presence of blood later, in who knows possibly during, you still think it would be fairly small enough risk to not warrant PEP?  I am currently at the 36 hour mark.  From what I understand, not every exposure guarantees infection. 

Thanks again for puttin my mind at ease

[Ann]

Prof,

It's your call. I wouldn't recommend PEP for this situation, although others might. PEP guidelines say this situation would be up to the discretion of the prescribing doctor. If you're really worried, go see a doctor about it. If you are prescribed PEP, make sure you're given a rapid hiv test first, to ensure you're not already hiv positive from some other incident.

Please be aware that PEP will increase your testing window period by four weeks - the amount of time you take the meds.

I would not expect you to test positive over this situation, PEP or no PEP. It's your call and by all means, get a second opinion if you feel the need.

Ann