Sexually Transmitted Diseases/HIV risk, semen on anus

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Question
Hi,
I'm a 23 years old male. I had sex with an unknown person a couple of months ago but I still feel uneasy about the situation. We didn't have anal sex. I gave him unprotected oral sex when I had a little bit of sorethroat. And the morning later I really had sore throat, I think because it was already irritated before I performed oral sex and after oral sex it got worse. So I was wondering if I am at risk of contacting HIV knowing that I had a sore throat when I performed an unprotected oral sex? And after oral sex, he came on his stomach. After cleaning himself, he bend over me, poking me with his penis while I was masturbating. So he poked around and on my anus for a while, and I was feeling that his penis was wet, most probably because he had semen on it still. I might have had some cuts on my anus that day because I shaved that part. Is it possible to get HIV like this?

Thanks a lot for your help,
John

Answer
Hello John,
Semen and precum is somewhat alkaline, and having it in your already mildly irritated throat can probably increase the irritation on the day after. And if your friend was HIV positive (without being on medications), his cum on your abrased anus does put you at some degree of increased risk.  I would have yourself checked now, and in 2-3 months; if you have an ability to use post exposure prophylaxis (within 72 hours after potential exposure), than that might be something to initiate now. However, it is not a likely scenario that you would get HIV infected from such an activity.  

Pre-exposure prophylaxis (PrEP) is also something to consider and discuss with your health care provider.

Good luck!
--mark  

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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