How likely am I to be HIV + ?

[Orlando75]

Hi,

I am a guy and I had sex with a guy about a week ago. This was the first time, I wanted to experiment but didn't count on things going so far - I was a little drunk.

We gave each other oral which was unprotected. He gave me anal which was protected. However, I am unsure if the condom broke as I felt a kind of popping, or snapping. I'm not sure if it was due to air the condom or the condom broke. 

The night after I woke up in a sweat from head to toe, then slept for hours. I've had a light flu since. I've already been to the docs who've said it's too early and re-booked me.

I pretty convinced I have HIV and I am preparing my mind for the result. Oh, I should add that this was a one night stand with someone I had not really known and it came to light later that he was very sexually active.

I live in the UK and the guy was English.

How likely is it I am HIV positive?

Thanks.

[Ann]

Orlando,

How long is a piece of string? There is no way of accurately answering your question "how likely is it...". However, given the circumstances (you don't actually know if the condom broke and it was a one-off), it's not terribly likely. The odds are in your favour of testing negative, but I'm not going to put any "X in Y" type specific odds on your situation.

What I can tell you with certainty is that the sweating you experienced the night afterwards had nothing to do with hiv even if you had been infected. The symptoms that some (not all) people experience following infection are not due to the virus itself. They are due to the process the body goes through while creating antibodies, and this takes around two to three weeks to happen. Certainly not a mere 24 hours.

You were only at risk if - IF - the condom broke and he came inside you. The guy most likely would have said something if the condom broke, but I'll concede that maybe he didn't. Hearing a noise doesn't necessarily mean the condom broke anyway - but I would advise you that if you ever have doubt over something like this, you check it out for yourself.

When you bottom, you need to be vigilant that your top is 1) using a condom 2) using it correctly 3) hasn't removed it without your knowledge and 4) it hasn't broken at some point during the intercourse.



Protected intercourse isn't a risk, but as you are unsure whether or not the condom broke you'd be wise to test at the appropriate time. The earliest you should test for hiv 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 is highly unlikely to change, but must be confirmed at the three month point.

You should also test for all the other, much more easily transmitted STIs. As you were the bottom, make sure they know at the GUM clinic so they can do rectal swabs. Don't be embarrassed - they do these types of procedures all the time and they've seen it all. They're there to help you, not judge you. We're not here to judge you either, by the way.



As you're new to this, I'll explain in detail about correct condom usage. This might be a little long, but read it if you really want to know how to take care of yourself. I realise you're probably young and nobody has taught you any of this. I'm taking the time, so read.

There are two main causes of condom breakage. Listen up - when you're bottoming you are at a much higher risk when a condom breaks than when it happens while you're topping.

There are two main causes of condom breakage.

One is not using enough water-based lube. Not using enough (or any) lube causes friction that may break the condom. Do NOT use oil based lube with latex condoms.

The other is having an air bubble in the tip. When putting a condom on, you need to pinch the tip between the finger and thumb of one hand, while rolling it down with the other.

Once it's on, give it a firm stroke from tip to base while watching the tip. If there is air in the tip, you'll see it. If there IS air in the tip, roll it back up and try again.

If it's dark and you can't see the tip well, when you do (what I call) the "stroke test", when you get to the bottom of the stroke, keep a firm grip of the condom and penis at the base and feel the tip with your other hand.

If there IS air present, you'll feel the bubble making the tip stand up and away from the head of the penis. If there is NO air, the tip will be sucked up tight against the head of the penis.

Once you're sure there is no air bubble in the tip, apply plenty of water-based lube and go for it.

When you're bottoming, you can put the condom on your top to make sure it's on correctly and with no air inside. Even if your top puts the condom on himself, you can still give him the stroke test before you let him enter you. I would strongly advise you to do it every time. 

I would also advise you that when you bottom, you reach down periodically to make sure the condom is still on your top. Any time you change positions, have a quick look or feel to make sure the condom is still on him and intact (not broken).

You can use the opportunity to apply more lube if needed. Keep in mind that you are far more likely than your top is to know when more lube is needed. If the only lube available is saliva (not advisable but better than nothing and better than something oil-based) use your own to make sure you are well lubed (not for any fear of hiv). Just spit on your fingers and wipe it on your bottom.

For the record, I follow the instructions I've given you every time I bottom - which is every time, being a woman. The ONLY time I ever had a condom break was once when I neglected to do the stroke test. (And no, he didn't get infected.)

I know this is already long, but I'm also going to give you my standard prevention talk. Keep reading.

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!

I know this is long but I hope you read the whole thing - read it a few times. You're young and I want you to understand how to protect yourself - and have fun while doing it.

Bottom line in your situation - yes, you're wise to test, but if that condom didn't actually break, you're sure to get a negative result. If it did break, you still have a very good chance of coming out of this ok.

Ann

[Orlando75]

Thank you Ann. I realize the question was quite vague. I have read it all and will re-read. Thanks for not judging and for all the helpful advice. 

[Ann]

Orlando,

You're welcome. That's what we're here for.

One thing I neglected to address yesterday was something you mentioned; "I live in the UK and the guy was English."

You need to understand that hiv doesn't know where someone lives, it doesn't know what ethnic or racial group a person belongs to, nor does it know any thing else about a person. It only knows that it wants to live in a human body, any human body.

It's not WHO you do, it's HOW you do it. You should never base your condom usage on who a person is, where they live, or what a person tells you about their hiv status (or their sexual health status in general). You should use condoms with anyone until you're in a monogamous relationship with them and have both tested together.

Asking a person their hiv status doesn't work because often times people don't know they're hiv positive and will believe they're being honest when they say they're hiv negative. And unfortunately, sometimes people will lie, although these people are in the minority. Most simply don't know they're poz because most people neglect to have regular sexual health check ups.

Wrap it up, or make sure they wrap it up, and you won't have to worry about hiv status - even if they do happen to be poz. Condoms have been proven to prevent hiv infection. Seriously.

Good luck with your testing. I do expect you to come out of this ok.

Ann

[Orlando75]

Thanks again for the info Ann. Yeah,I asked about being English because they asked me at the clinic if the other person was foreign or English. I guess they're were trying assess the risk in some way.

Can I ask you another question? I've recently discovered about PEP - Post Exposure Prophylaxis. I visited the clinic within 72 hours. I'm wondered why, if I told them I believed I am at risk, they would not have mentioned it? Is PEP taken seriously by doctors and are they all aware of it?

FYI: I am preparing the worst. I still have a flu, lack of energy and starting to itch all over. I'm just trying to learn as much as I can before the (probable) inevitable result. Sites like this are really helpful though.

I appreciate your time. Thanks,

Orlando.

[Ann]

Orlando,

If you went to a GUM clinic, they would be aware of PEP. However, you had protected intercourse and you don't actually know if the condom broke or not. PEP consists of two or three very strong meds and they're normally only given if a definite risk has occurred. They're not like prescribing a few paracetamol.

If you went to an A&E or GP, it may be they weren't aware of PEP, but if I understand your first post correctly it sounds like you went to a GUM. (Actually, some health care trusts are re-branding their GUM clinics as sexual health clinics. But anyway...)

Stop automatically reading hiv into your symptoms. It's cold and flu season and there's a lot of bugs about right now. Your symptoms are in no way hiv specific and symptoms will never tell you a single thing about your hiv status - ONLY testing at the appropriate time will.

Ann