Expert: Kristen Brannock, MPH - 3/21/2007

Question
QUESTION: Hello Doctor -

I truly appreciate your sense of caring in answering these questions.

Could you please help me calm down and look at the level of risk I was at during a recent sex act realistically?

You see, I am a 29 year old gay male who recently received protected anal sex from a stranger while on a vacation in Thailand.

Unfortunately, I made a big mistake and allowed him to penetrate me for approximately 15 minutes without wearing a condom.

(After using a condom for sometime he removed it and then proceeded to enter me . . .)

As soon as I realized the mistake I immediately stopped the unsafe sex act, and I do not believe there was ejaculation inside me, but nonetheless I have been traumatized by the event.

Since, I believe I engaged in a high-risk situation, could you please advise me on what I should do next, and how anxious I should feel?

I am specifically concerned about the possibility of my partner ejaculating into the condom when it was in use, and then, after removing the condom, the risk involved in the penetrative sex that took place without protection.  (again, this was for about 15 minutes.)

Ugh.  I am so embarrassed by all of this . . .

Incidentally I asked this stranger his HIV status, and he said it was negative - but I am not so sure I should trust anyone who would put both of us at risk like this.

Please advise?

Thank you!

ANSWER: You're right that you should *always* use a condom (correctly) during sex to reduce the risk of transmitting or acquiring any infections.

Don't be emabarrassed...we all make mistakes.

Unprotected anal sex is the most risky of sex acts. If he did not ejaculate inside you, that lowers the risk. However, preseminal fluid can transmit HIV; and, if he had ejaculated in the condom and then took it off, semen could have remained on his penis and then entered your body during the unprotected sex.

I can't tell you how anxious you should feel- I can say that you have put yourself at risk and I would suggest getting an HIV test. There is a window period with the test (1-3 months) so test after 3 months post-exposure for a definitive test result.

---------- FOLLOW-UP ----------

QUESTION: Kristen -

Thank You again for the information.  Just one last question, as I am sure you are quite busy . . .

Yes, this was an at risk activity, however is there any sense of solace in knowing that it only went on for about fifteen minutes?

I am certainly going to get tested.  I will test at one month just for my own anxiety reduction, and again at three months.

Also, in your field of work, do these sort of mistakes happen a lot?  Do others get themselves into these kinds of situations?

Answer
The *time* involved really isnt the issue (unless longer penetration equals more risk of rectal tearing and more area for HIV to enter the body), it has more to do with the presence of semen.

Actually, I hear things like this a lot. You are definitely not alone.