Expert: John Thai, M.D. - 1/8/2008

Question
On New Years Eve I had protected receptive oral and anal sex with what I
think was a hispanic man who I know nothing else about.  The sex lasted a
really short time, I didn't feel him ejaculate inside of me.  What I'm most
scared about is that since I was receptive I don't know what was going on
behind me alot of the time.   But if I remember correctly I told him to put a
condom on immediately, he did, I gave him protected oral, and then we had a
very short session in which I received him anally.  I was surprised when he
said he was "done." and then he masturbated and ejaculated on my lower
back.  He tried to insert himself once unprotected before ejaculating on my
lower back but I didn't let him.  I asked him after wards if he wore a condom
(to make sure he didn't take it off) and he said yes and reported no slippage
or breakage (even though it didn't seem like there would have been time for
that to occur), should I worry that he might have just not told me?  Sorry this
is so long I just want this to be as detailed as possible.  

What do you think my chances are of getting infected with HIV?
If I were to be infected, how long does it take for someone to be able to
transmit?
When is the absolute soonest I could test positive?  other times I could test
that come before 3 months?


Answer
Hi Will,

Due to your circumstances, the only answer would be based on "assumptions." As a physician, it is a general rule to not make assumptions as I was not present at the time of the event. You have every right to be concern of your health due to the possibility of a bareback situation. The chances of HIV transmission is high as you were a bottom, if it was barebacked and there were precum or ejaculate.

There are more sexually transmittable infections than HIV. Thus, I highly recommend that you seek a complete STI screening at your local free STI clinic run by your local health department or a non-profit organization with a licensed physician.

The only way to prove that you did not contract HIV is by having an HIV test. The soonest you can test for HIV is a few days from the time of your intercourse. However, this test is very expensive and there are guidelines that need to be met in order for your physician to order it. The test is call a p24 HIV test. The general rule is that unless you have been raped, the test will not be offered.

The second test is NAAT (nucleic acid amplification testing). It is relatively accurate (99%). The earliest you can test for this is 2 weeks from the date of the event.

The third test is the EIA and rapid testing. The general rule is 10-12 weeks from the event. This is widely offered as it is cheap and you can obtain your results within 20 minutes.

If you were infected, the only way in which you can infect others is if there was a high number of HIV virus in your bodily fluids (i.e. blood, semen). The time frame differs in everyone.

Regards,

John Thai, MD