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TheBugDoctor
TheBugDoctor, Doctor (MD)
Category: HIV and AIDS
Satisfied Customers: 1549
Experience:  I am a Board Certified Infectious Diseases physician with many years experience treating a broad range of infectious diseases.
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Hello, I recently had a sexual encounter with an HIV positive

Customer Question

Hello,

I recently had a sexual encounter with an HIV positive person. We used protection for most of it, but there were four instances that may have been unsafe.

1.) I performed oral sex on him (no ejaculation)
2.) He performed oral sex on me (no ejaculation)
3.) He inserted his penis into my anus for just one second before I told him to put a condom on. He removed his penis and put on a condom.
4.) He ejaculated on my chest. I didn't wash it off right away, and it might have gotten on my hands and potentially on my penis later.

I was worried about what happened, so I began PEP treatment 30 hours after exposure.

What are my chances of contracting HIV from him?

Thank you,
-A
Submitted: 2 years ago.
Category: HIV and AIDS
Expert:  TheBugDoctor replied 2 years ago.

Hello A-

 

The risk of the type of exposure you describe is fairly low- but obviously not 0.

Without PEP, anal intercourse - the riskiest thing you describe- has a risk about 0.5% per sex act. IN some people it can be higher, if the infected partner has a higher viral load, or there is more trauma, blood exchange, or other concomitant STDs.

 

PEP is thought to lower the risk by at least 80%- and likely more with current multi-drug PEP. Unfortunately waiting 30 hours later lowers the benefit rather substantially, so I am not sure how helpful the PEP would be.

 

Overall , the risk is low- but obviously you should have follow up testing at 4-6 weeks, and 3 months.

 

Good luck

 

Always ask if you need clarification/more information.


POSITIVE feedback & a BONUS are warmly appreciated.
Please note that answers are for information only, do not take the place of an IN PERSON assessment by your doctor,
and does not establish a patient-physician relationship.

Customer: replied 2 years ago.
30 hours would make the PEP ineffective? I was told that it was effective if started within 72 hours...
Customer: replied 2 years ago.
And is the risk of anal intercourse per sex act 0.5% as in "less than half a percent"?


Expert:  TheBugDoctor replied 2 years ago.

The sooner it is started the better.

The concept is to start before the virus attaches to receptor cells, and potentially incorporates into your DNA.

Beyond 24 hours the effectiveness is likely questionable.... although recommendations do not say not to use it, in high risk cases even beyond that. But based on animal models it is unlikely to be effective beyond 1 day.

 

Always ask if you need clarification/more information.


POSITIVE feedback & a BONUS are warmly appreciated.
Please note that answers are for information only, do not take the place of an IN PERSON assessment by your doctor,
and does not establish a patient-physician relationship.

Expert:  TheBugDoctor replied 2 years ago.
Yes 0.5% is a half percent
Customer: replied 2 years ago.
So should I stop taking the PEP?
Expert:  TheBugDoctor replied 2 years ago.

At this point, I would probably continue.

 

But like I noted, the benefit is minimal.

This may be something to discuss with your doctor/ or preferably an infectious diseases doctor in person.

 

Always ask if you need clarification/more information.


POSITIVE feedback & a BONUS are warmly appreciated.
Please note that answers are for information only, do not take the place of an IN PERSON assessment by your doctor,
and does not establish a patient-physician relationship.

TheBugDoctor, Doctor (MD)
Category: HIV and AIDS
Satisfied Customers: 1549
Experience: I am a Board Certified Infectious Diseases physician with many years experience treating a broad range of infectious diseases.
TheBugDoctor and other HIV and AIDS Specialists are ready to help you
Customer: replied 2 years ago.
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