Possible exposure

[operatic19]

Hello everyone! I am new to this forum and had a question about a possible exposure that I needed some light shed on. Well in March, not exactly sure what day, I had a sexual encounter with a guy who I now know to be HIV+. Basically what happened was that he performed oral sex on me for about a minute or so, and then we had anal sex (with a condom) for about 3-5 minutes. I was the top the entire time. After I had finished he wanted to as well and asked me to keep going so I did. I noticed I was fighting hard to keep an erection. When I came out, I noticed the condom was not on me, but I didn't notice the "frayed hula hoop" typical of broken condoms. I asked him if he was HIV/STD free and he told me yes. I for some reason didn't believe him, with good intuition. I paid attention to my body ever since then, and I haven't had any symptoms typical of ARS but I do know you can have HIV and not have ARS. Also I might add that he told me, recently as a matter of fact, that he is undetectable and gets tested regularly. That didn't led me to think that he is taking meds though. He did tell me that I can't get anything from him, which is completely far from the truth. I have been very paranoid and slightly depressed over this incident, but I'm remaining optimistic no matter what the outcome. I am getting tested on the 14th and it would be a lie if I said I wasn't scared. Can anyone tell me just how risky this exposure was (and I know it was very high risk)?

Also I'd like to add that I'm 19 years old, and never had a high risk exposure before. There were no open sores or cuts on the head of my penis of anywhere else. No blood was on my penis either, but I know this doesn't mean anything as far as anus mucus membranes are concerned.

[jkinatl2]

Hey, operatic. Thanks for posting!

First things first.

I merged your two messages together. You might not have read this, but in this part of the forums you only get THREE free posts before you have to take out a subscription. I merged your posts to give you two, rather than one, free post. I suspect that you will have more questions than some, because the risk assessment is nuanced. More on that in a sec.

Secondly, as you are not HIV positive, you can READ the other forums but can ONLY post on this one and in "off topics" where we don't allow HIV related talk. Just wanted to state the obvious


Okay, now to your situation.

I am going to give two risk assessments, with two hypotheses.

A) your partner was telling you the truth. He is HIV+, undetectable, and adherent to his meds.

B) Your partner was not on meds at all, had a soaring viral load, and had secondary STD lesions in his rectum that facilitated a huge spike in his rectal viral load.

(you can tell this is two totally different extremes, of course.)

A) Your sex was not risky. If the bottom partner is on meds and his viral load is undetectable, AND he has no STD-related lesions in his rectum that might spike a viral load even in an otherwise undetectable (UD) person, then your risk was nil.

These variables are important, though. Not everyone (probably not most people you will encounter) is the "perfect storm" of infectiousness, but most folks who are not adherent to meds fall somewhere along the spectrum.

So on the other end of that spectrum:

B) You have had a risk, albeit far smaller than you imagine, and should test. There are risks to topping  unprotected, but it is FAR more difficult for HIV to transfer from bottom to top than the other way around.

YOUR only vulnerable area(s) are: Your urethra, the hole at the tip of your penis, and, if you are uncircumcised, certain dendretic cells underneath your foreskin.

Another caveat is that you were protected by that condom for almost the entire time. It's not unusual for a condom to detach from the top if he grows soft after sex but still wants to penetrate his partner to help him finish.

Given the mechanics of HIV and the stats, I would say that under the WORST case scenario you might consider testing at three months (with a full STD panel, like all sexually active folks not in mutually monogamous relationships do) just to be absolutely sure (ease of mind). I would be shocked if you tested positive for this event, even under the worst case scenario.

And you are likely somewhere FAR closer to the best case scenario.

So if you want to test for peace of mind, test at six weeks (the result is HIGHLY unlikely to change) and again at three months (which is still the global standard, and this is a global site) and know that you did the right thing. You used a condom for penetrative sex.

I honestly do not think you have much of a risk, if you have any risk at all, from the encounter you described. 

Just please know that some people might not even know they are infected, which might mean a HUGE viral load. You might have already encountered one of these people. That is why you use condoms. You are at FAR greater risk of HIV from someone who is unaware of his HIV status and recently infected that you can EVER be from someone who is aware of, and successfully treating, his HIV infection.

[Ann]

Operatic,

When you pull out of your bottom, you need to hang on to the base end of the condom so it doesn't slip off and remain inside the other guy. This is particularly important if you've gone soft, because the condom is more likely to slip off when you're soft.

While leaving the condom behind isn't a risk to you hiv-wise, it's just not a good idea. The only time a slipped condom is an hiv risk is if it happens sometime during the act and the condom gets pushed up inside the other person and you end up being inside without a condom on.

It does not sound like this is the case in your situation. It sounds like it came off as you withdrew and that is NOT a risk.

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. 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

[operatic19]

Just wanted to tell everyone that since my last exposure in March, I finally bought the Oraquick test today. And *drumroll* TESTED NEGATIVE! It's been more than three months since the exposure so I am very grateful to have that result. However, this has inspired me to really become an activist for HIV/AIDS and to get people to get tested and practice safer sex. You guys were wonderful to talk to and I wish you all the best in your lives! Maybe, God willing, I become a famous opera singer and can use my voice not only to sing but to make people aware that this disease can be 100% prevented with safer sex and abstinence, as well as staying away from drugs and alcohol. I seriously thank God for teaching me this lesson and you all as well. I admire each and every one of you for being able to handle this disease with grace and poise, and being brave every step of the way. Take care everyone! <3

[Ann]

Op,

Good to hear. Don't forget to get a FULL sexual health check up at least once a year going forward. It's what responsible, sexually active adults do to protect their own health and the health of their sexual partners.

Make sure you read through the condom and lube links in my signature line so you don't have a condom mishap again in future.

Ann