Unprotected anal sex - PEP worth it?

[josephs26]

I am an HIV- gay man with no STDs (tested recently). 48 hours ago, a friend and I  had sex and we got carried away and he topped me without a condom. He said he is HIV- and was last tested in January and that he hadn't had any risky encounters since then. I know that what someone says should be taken with caution, but I have know him a few years, so he's someone I trust - although he's not a very close friend.

He is also almost exclusively a top, which presumably would decrease his HIV risk at least somewhat. He does hook up with guys from time to time, but he is not especially promiscuous and he does not engage in any particularly risky sexual activities (although he has topped other friends without a condom, but he rarely does so and said it had been a while since that happened last - before his last HIV text). He didn't ejaculate in me and didn't appear to have much, if any, precum. He wasn't in me very long (maybe a few minutes, at most), and was not being rough, or deep. And we used plenty of lube.

I know this put me at risk and I will have to test in 3 months. But should I consider PEP? I know I only have about 24 hours to decide, so weighing the options here.

Thanks for any insight.

[Andy Velez]

Yes, you should definitely consider doing PEP. You have had a high level risk for HIV. However well meaning your friend maybe, receptive anal intercourse is at the top of the list for risk sexually.

The sooner you get PEP started the better. It's a highly effective treatment when begun in time.

You take it for 28 days. You can test for a conclusive and hopefully negative result at 3 months after the completion of PEP.

What you have described of length of time, etc., would make it less likely for you to have become infected, but that's only guessing and HIV status is never somethng to guess about. By the way, if you decide not to do PEP you should still get tested at 3 months after the incident to hopefully confirm your negative status.

In the future you can have all the anal sex you want to regardless of the status of the other guy. Just do it the safer way which means the insertive partner is always wearing a condom.

Good luck to you.

[josephs26]

Thanks for the quick response. The update is that this morning (still in the 72 hour window), I talked with my friend and he agreed to get tested again at a place that does rapid tests. His called me to say that his test came back negative. I do realize that a negative test today doesn't entirely erase the risk - he could have acquired HIV in the past month or so and it would not necessarily show up yet. But given the news of this new test, I'm not going to do PEP. I would imagine a doctor wouldn't likely even prescribe a PEP course for me at this point.