What is my risk of contracting HIV?
December 9, 2011 12:22 PM Subscribe
He is HIV+, I am not. Have our activities put me at risk? (potentially NSFW)
I (male) met a guy recently, who I have begun seeing. He has since told me that he his HIV+. I really like him, and plan on continuing to see him. However, I would like to make sure that I am being safe.
Prior to his informing me, we made out and I performed oral sex on him. Less than a few minutes, just until an erection was achieved. We have not gone any further, and have agreed to practice safer sex in the future, including condoms for oral sex.
I am trying to determine what my risk of contacting HIV was during that brief contact so that I do not worry unnecessarily. From what I understand, unprotected oral sex is lower risk than other unprotected activities. There was some, but not much of an opportunity for fluid exchange. He is very healthy, and his viral load is undetectable (below the sensitivity of the test). As a precaution, I plan on getting tested. But how long should I wait? Should I be seeking post-exposure prophylaxis? This occurred one week ago. I understand YANMD.
Additional advice/resources on relationships between partners of mixed status would be greatly appreciated.
Throwaway account: anonymefi123@gmail.com
I (male) met a guy recently, who I have begun seeing. He has since told me that he his HIV+. I really like him, and plan on continuing to see him. However, I would like to make sure that I am being safe.
Prior to his informing me, we made out and I performed oral sex on him. Less than a few minutes, just until an erection was achieved. We have not gone any further, and have agreed to practice safer sex in the future, including condoms for oral sex.
I am trying to determine what my risk of contacting HIV was during that brief contact so that I do not worry unnecessarily. From what I understand, unprotected oral sex is lower risk than other unprotected activities. There was some, but not much of an opportunity for fluid exchange. He is very healthy, and his viral load is undetectable (below the sensitivity of the test). As a precaution, I plan on getting tested. But how long should I wait? Should I be seeking post-exposure prophylaxis? This occurred one week ago. I understand YANMD.
Additional advice/resources on relationships between partners of mixed status would be greatly appreciated.
Throwaway account: anonymefi123@gmail.com
I am not a doctor, this is not medical advice, etc. Given all the factors (brief contact, the type of contact, and his low viral load), it's probably pretty unlikely that you contracted HIV, but it's a good idea to get tested regularly if you are engaging in any sexual contact with someone who is HIV+.
Take a look at GMHC's overview, which contains good info about transmission risk. You can also call them if you want to talk to someone, especially about partners of mixed HIV status; they are very well-versed in those issues.
posted by bedhead at 12:37 PM on December 9, 2011 [3 favorites]
Take a look at GMHC's overview, which contains good info about transmission risk. You can also call them if you want to talk to someone, especially about partners of mixed HIV status; they are very well-versed in those issues.
posted by bedhead at 12:37 PM on December 9, 2011 [3 favorites]
I think your risk is pretty low, but it concerns me that he didn't tell you of his status before commencing sexual activity with you.
It seems very irresponsible of him not to allow you to make an informed choice about what risks you wanted to expose yourself to. I know you say he's great, but this would give me pause for thought about embarking on a relationship with him.
posted by lwb at 12:38 PM on December 9, 2011 [35 favorites]
It seems very irresponsible of him not to allow you to make an informed choice about what risks you wanted to expose yourself to. I know you say he's great, but this would give me pause for thought about embarking on a relationship with him.
posted by lwb at 12:38 PM on December 9, 2011 [35 favorites]
Like all sexual activity, oral sex carries some risk of HIV transmission when one partner is known to be infected with HIV,
It's a low risk but it is a risk. I'd be far more concerned that he did not disclose this to you prior to your having sex or at least insist on an oral barrier of some sort.
posted by Poet_Lariat at 12:38 PM on December 9, 2011 [3 favorites]
It's a low risk but it is a risk. I'd be far more concerned that he did not disclose this to you prior to your having sex or at least insist on an oral barrier of some sort.
posted by Poet_Lariat at 12:38 PM on December 9, 2011 [3 favorites]
I think the risk is very, very low for what you've done but it is strange that he didn't mention it.
posted by The Lamplighter at 12:41 PM on December 9, 2011 [6 favorites]
posted by The Lamplighter at 12:41 PM on December 9, 2011 [6 favorites]
"There is no scientific evidence that HIV is passed through saliva, tears, or sweat." so the making out is not a risk factor. The unprotected oral sex is a low vector.
HIV tests are not accurate until 4 weeks, but can take up to 3 months before the antibodies build up which is what the test reads. The technology is probably evolving so I wouldn't be surprised if there are new methods of testing. You should talk to a doctor or clinic.
Personally, I would be furious if I put my hand or anything else near someones crotch in a romantic situation and they didn't tell me about something like this. You don't wait until the heat of the moment either. That's not the most rational time for anyone.
posted by OnTheLastCastle at 12:45 PM on December 9, 2011 [2 favorites]
HIV tests are not accurate until 4 weeks, but can take up to 3 months before the antibodies build up which is what the test reads. The technology is probably evolving so I wouldn't be surprised if there are new methods of testing. You should talk to a doctor or clinic.
Personally, I would be furious if I put my hand or anything else near someones crotch in a romantic situation and they didn't tell me about something like this. You don't wait until the heat of the moment either. That's not the most rational time for anyone.
posted by OnTheLastCastle at 12:45 PM on December 9, 2011 [2 favorites]
If you want to be safe, don't date people who deceive you about having deadly communicable diseases. At the very least, if a man didn't tell me he had HIV and let me perform oral sex on him, I would not take his word for it that he is healthy and has a low viral load. I'd insist on seeing actual medical test results. Even if he thinks oral sex with him is a safe activity (and it's certainly safer than a lot of other things you could have done), that's not his decision to make, and I wouldn't consider it "safe" to date someone who thinks it's okay to put you at risk just because it's a risk he thinks should be low enough not to count.
posted by decathecting at 12:48 PM on December 9, 2011 [12 favorites]
posted by decathecting at 12:48 PM on December 9, 2011 [12 favorites]
It would be pretty unforgivable to me if someone failed to disclose before any sex act but if what he is telling you is true, go to a dr. And ask when you should take the test just to make sure. They will tell you the risk is very low but a yearly test whether or not you believe you've been exposed is a healthy thing to do. But...is he telling the truth? Do you have any proof he is taking meds and has a very low viral count. I would worry more about the lie than your possible exposure.
posted by boobjob at 12:49 PM on December 9, 2011 [6 favorites]
posted by boobjob at 12:49 PM on December 9, 2011 [6 favorites]
By performing oral sex on him, even without him ejaculating, he may still have passed a small amount of seminal fluid on, so I would say it would be best to get tested just to be sure.
Frankly, him making no mention of his condition before letting you put yourself into this position is disgusting and potentially harmful and I wouldn't want anything to do with anyone willing to put my life at risk so they can get their rocks off.
posted by DuchessProzac at 12:50 PM on December 9, 2011 [1 favorite]
Frankly, him making no mention of his condition before letting you put yourself into this position is disgusting and potentially harmful and I wouldn't want anything to do with anyone willing to put my life at risk so they can get their rocks off.
posted by DuchessProzac at 12:50 PM on December 9, 2011 [1 favorite]
Dude. This person knowingly kept you in the dark and you still want to date them?
Every time I've met someone who holds back vital info like this, there is always more dirt hiding under the rug. Always. Deal-breaker-type dirt.
The HIV status is the MacGuffin here. Don't see this person again because they don't place priority on the well-being of others in situations where doing so is entirely sole their responsibility AND duty.
There is no excuse. Move on.
And keep getting tested for the next 4 to 6 months. Be super responsible in your sexual interactions during that time - read: Don't Put Partners At Risk Without Their Knowledge And Consent.
Best to you.
posted by jbenben at 12:58 PM on December 9, 2011 [6 favorites]
Every time I've met someone who holds back vital info like this, there is always more dirt hiding under the rug. Always. Deal-breaker-type dirt.
The HIV status is the MacGuffin here. Don't see this person again because they don't place priority on the well-being of others in situations where doing so is entirely sole their responsibility AND duty.
There is no excuse. Move on.
And keep getting tested for the next 4 to 6 months. Be super responsible in your sexual interactions during that time - read: Don't Put Partners At Risk Without Their Knowledge And Consent.
Best to you.
posted by jbenben at 12:58 PM on December 9, 2011 [6 favorites]
Have our activities put me at risk?
There are some that will say that unprotected oral sex is high risk. But I know a lot of positive men, and none of them who weren't drug users believe that they caught the virus any other way than receiving unprotected anal sex. The bar is set higher than that to be considered truly safe, as I think it should be. But getting it from 'typical' (no gaping open sores on either end) non-ejaculating oral sex is so unlikely that many people in mixed-status partnerships do not worry about condoms. However, if you want to use condoms for oral sex in the future, I say good for you. Whatever makes you comfortable.
That said...
He is very healthy, and his viral load is undetectable (below the sensitivity of the test).
means I'd bet my own similarly undetectable status that you have absolutely nothing to worry about.
But that said you should get tested. Because that should just be a regular habit of any sexually active gay man.* End of story. Consider this my advice for partners of mixed status as well especially if you plan on having regular sex with a positive man.
* Soapbox: HIV isn't a manageable disease just because we know it is -- even though this message is often lost on those unfamiliar. It's manageable only if you know you whether or not you have. That's what makes being positive in 2011 a thing that's pretty easy to forget you even have beyond a nightly pill and a check-up every 3 months. It's not knowing and/or not taking care of it that means it's still deadly for too many people.
I think, it it will put your mind at ease, you should talk to a health care professional about PEP. I'm not familiar with it (obviously...sorry, macabre humor may not funny to you right now) so I have no idea about the time frame, but again, it's something you should learn as much as possible about, especially for your relationship going forward.
Overall, HIV is scary because (a) it can be a scary thing and (b) it's something people should be scared of. But like everything else, it's a lot less scary when you shine the light of knowledge on it. If there's any thing you need or any questions you have, please feel free to contact me over MeFi mail or at the email address in my profile.
posted by MCMikeNamara at 1:01 PM on December 9, 2011 [6 favorites]
There are some that will say that unprotected oral sex is high risk. But I know a lot of positive men, and none of them who weren't drug users believe that they caught the virus any other way than receiving unprotected anal sex. The bar is set higher than that to be considered truly safe, as I think it should be. But getting it from 'typical' (no gaping open sores on either end) non-ejaculating oral sex is so unlikely that many people in mixed-status partnerships do not worry about condoms. However, if you want to use condoms for oral sex in the future, I say good for you. Whatever makes you comfortable.
That said...
He is very healthy, and his viral load is undetectable (below the sensitivity of the test).
means I'd bet my own similarly undetectable status that you have absolutely nothing to worry about.
But that said you should get tested. Because that should just be a regular habit of any sexually active gay man.* End of story. Consider this my advice for partners of mixed status as well especially if you plan on having regular sex with a positive man.
* Soapbox: HIV isn't a manageable disease just because we know it is -- even though this message is often lost on those unfamiliar. It's manageable only if you know you whether or not you have. That's what makes being positive in 2011 a thing that's pretty easy to forget you even have beyond a nightly pill and a check-up every 3 months. It's not knowing and/or not taking care of it that means it's still deadly for too many people.
I think, it it will put your mind at ease, you should talk to a health care professional about PEP. I'm not familiar with it (obviously...sorry, macabre humor may not funny to you right now) so I have no idea about the time frame, but again, it's something you should learn as much as possible about, especially for your relationship going forward.
Overall, HIV is scary because (a) it can be a scary thing and (b) it's something people should be scared of. But like everything else, it's a lot less scary when you shine the light of knowledge on it. If there's any thing you need or any questions you have, please feel free to contact me over MeFi mail or at the email address in my profile.
posted by MCMikeNamara at 1:01 PM on December 9, 2011 [6 favorites]
In terms of your medical risk, there is some risk and you should get tested. As others have mentioned, this may be a red flag for your relationship.
However, to put this in context, there is a very low risk of transmission per sex act, and this is a relatively low-risk act.
This oft-cited study shows a rate of of HIV transmission at 0.0082/coital act (for the most contagious group of recently-infected index partners) with rates that go down to 0.0015/coital act for index partners who have been HIV positive for more than 6 mos. (which sounds like it's the case.)
This is not to say you shouldn't worry, or that you shouldn't ask a doctor if post-exposure prophylaxis makes sense, just that statistically speaking, your risk is low.
That all being said, if it were me, I'd go to planned parenthood, or a local sexual health clinic and see if I could get the PEP, more for my mental health over the next few months thant the actual likelihood of transmission.
posted by mercredi at 1:03 PM on December 9, 2011
However, to put this in context, there is a very low risk of transmission per sex act, and this is a relatively low-risk act.
This oft-cited study shows a rate of of HIV transmission at 0.0082/coital act (for the most contagious group of recently-infected index partners) with rates that go down to 0.0015/coital act for index partners who have been HIV positive for more than 6 mos. (which sounds like it's the case.)
This is not to say you shouldn't worry, or that you shouldn't ask a doctor if post-exposure prophylaxis makes sense, just that statistically speaking, your risk is low.
That all being said, if it were me, I'd go to planned parenthood, or a local sexual health clinic and see if I could get the PEP, more for my mental health over the next few months thant the actual likelihood of transmission.
posted by mercredi at 1:03 PM on December 9, 2011
To clarify - the rates in that study are for vaginal intercourse, and would therefore be higher than your risk.
posted by mercredi at 1:06 PM on December 9, 2011
posted by mercredi at 1:06 PM on December 9, 2011
There are some that will say that unprotected oral sex is high risk.
Uh, who? Oral sex is very low risk of transmission. Which isn't exactly the same as no risk, particularly for the partner performing the oral sex (I believe the number of documented cases of the partner receiving oral sex being infected is near zero) but can't be said to be high risk.
The serious issue here is allowing you to perform oral sex before being told your partner was HIV+. Because, as I said, very low risk isn't the same as no risk.
posted by Justinian at 1:08 PM on December 9, 2011 [1 favorite]
Uh, who? Oral sex is very low risk of transmission. Which isn't exactly the same as no risk, particularly for the partner performing the oral sex (I believe the number of documented cases of the partner receiving oral sex being infected is near zero) but can't be said to be high risk.
The serious issue here is allowing you to perform oral sex before being told your partner was HIV+. Because, as I said, very low risk isn't the same as no risk.
posted by Justinian at 1:08 PM on December 9, 2011 [1 favorite]
I was listening to a Dan Savage podcast on this very subject. He said that oral sex is a low risk activity, but that the lack of disclosure is not a good sign.
Apparently the below-detection issue is a concern to some public health folks because some HIV+ people sometimes use it as an excuse to practice unsafe sex.
posted by k8t at 1:20 PM on December 9, 2011 [2 favorites]
Apparently the below-detection issue is a concern to some public health folks because some HIV+ people sometimes use it as an excuse to practice unsafe sex.
posted by k8t at 1:20 PM on December 9, 2011 [2 favorites]
If you have to ask these questions you do not have the information necessary to be a responsible sexually active man who has sex with other men. Get to a gay resource center pronto and get educated. If there are none go to planned parenthood. PP is there for men as much as it is for women. Go!
As for him disclosing, you engauged in a very low risk activity. I wouldn't say disclosure is required for a little oral sex. If he forcefully shot down your throat that would be a different story. He did however disclose before you guys went further. That is good. You could conceivable transmit from just kissing yet I don't think many people would demand disclosure before that brand of oral sex.
posted by munchingzombie at 2:17 PM on December 9, 2011 [1 favorite]
As for him disclosing, you engauged in a very low risk activity. I wouldn't say disclosure is required for a little oral sex. If he forcefully shot down your throat that would be a different story. He did however disclose before you guys went further. That is good. You could conceivable transmit from just kissing yet I don't think many people would demand disclosure before that brand of oral sex.
posted by munchingzombie at 2:17 PM on December 9, 2011 [1 favorite]
Your risk is very low if he viral load is indeed undetectable, but how certain are you of that? Have you seen medical records?
posted by namesarehard at 2:30 PM on December 9, 2011 [1 favorite]
posted by namesarehard at 2:30 PM on December 9, 2011 [1 favorite]
Pozitively Healthy: a gay man’s guide to sex and health in Canada:
re: mixed couples - Magnetic Love: When positive and negative attract, HIV often takes a backseat to that crazy little thing called love. Four couples tell all about negotiating the serodivergent terrain.
posted by sadmadglad at 5:27 PM on December 9, 2011
The HIV risk table for HIV positive guys:It is probably helpful that his viral load is undetectable, but it's impossible to say. Sometimes people have undetectable viral loads in their blood but not in cum. Sometimes people have "blips" where their viral load shoots up for a day or two and then goes back down.
The sex: He (HIV-negative) sucks your cock without a condom on it.
The risk: Low risk
Some important details: The risk of passing on HIV is increased if he gets your cum or pre-cum in his mouth.
re: mixed couples - Magnetic Love: When positive and negative attract, HIV often takes a backseat to that crazy little thing called love. Four couples tell all about negotiating the serodivergent terrain.
posted by sadmadglad at 5:27 PM on December 9, 2011
Okay. Your risk here of getting HIV is like, negligible. Pretty much if you got HIV from this experience you would be close to a medical case history. (I would say it is VERY, VERY SLIGHTLY risky if he ejaculated in your mouth.) I say this as someone who was married to someone HIV+ for years, who has, uh, been around, who has been a professional HIV educator and an HIV test counselor: stop worrying about this.
If you went to get "post-exposure prophylaxis" at a hospital, they would pretty much laugh at you. (They might do it? But I think they'd sit you down and say "honey, with all due respect, this is for people who've been raped and/or people who have been the receptive partner in anal sex and had condom breakage.")
When we say "low risk," we mean LOW risk. Seriously. It's not like "oh maybe that knife cut on your skin will get infected, so put some antibiotics on it." It's not like "Oh, if you jump off that three-story building, you have a risk of breaking your leg." It's like... somewhere between "chances of having a car accident on the highway" but closer to "commercial airplane crash" risk.
You should ideally go get tested now (at a good place that you like!), get tested three months from now, and then get regularly tested. It's good for you to be in charge of your health! No matter where you're putting your mouth.
Please also know that testing is this super-loaded and stressful thing, but for no real reason. What are you going to do with your test results? Not much, really! You'd get a smart doctor and you'd, ahem, learn how to inform your sex partners of your status and define what you're comfortable doing.
Your experience here is an experience that a lot of people have and it helps give you the impetus to have discussions with other men before you do stuff in bed.
You should only be doing things that you're comfortable with--no matter how strange they sound or seem to others. If you'll only have sex with him while wearing a condom and eating a banana and wearing socks, then that's your call and that's your informed decision. You need to make guidelines that YOU feel completely great about and follow them. They may evolve over time, but it's important to listen to yourself. Sex should be great for you--and you can't enjoy it if you are stressing out after like this.
I am concerned a little bit that you are a dude having sex with dudes and you're not feeling settled about what's safe for you and what's not. Please Memail me or email me if you want to talk.
posted by RJ Reynolds at 7:33 AM on December 10, 2011
If you went to get "post-exposure prophylaxis" at a hospital, they would pretty much laugh at you. (They might do it? But I think they'd sit you down and say "honey, with all due respect, this is for people who've been raped and/or people who have been the receptive partner in anal sex and had condom breakage.")
When we say "low risk," we mean LOW risk. Seriously. It's not like "oh maybe that knife cut on your skin will get infected, so put some antibiotics on it." It's not like "Oh, if you jump off that three-story building, you have a risk of breaking your leg." It's like... somewhere between "chances of having a car accident on the highway" but closer to "commercial airplane crash" risk.
You should ideally go get tested now (at a good place that you like!), get tested three months from now, and then get regularly tested. It's good for you to be in charge of your health! No matter where you're putting your mouth.
Please also know that testing is this super-loaded and stressful thing, but for no real reason. What are you going to do with your test results? Not much, really! You'd get a smart doctor and you'd, ahem, learn how to inform your sex partners of your status and define what you're comfortable doing.
Your experience here is an experience that a lot of people have and it helps give you the impetus to have discussions with other men before you do stuff in bed.
You should only be doing things that you're comfortable with--no matter how strange they sound or seem to others. If you'll only have sex with him while wearing a condom and eating a banana and wearing socks, then that's your call and that's your informed decision. You need to make guidelines that YOU feel completely great about and follow them. They may evolve over time, but it's important to listen to yourself. Sex should be great for you--and you can't enjoy it if you are stressing out after like this.
I am concerned a little bit that you are a dude having sex with dudes and you're not feeling settled about what's safe for you and what's not. Please Memail me or email me if you want to talk.
posted by RJ Reynolds at 7:33 AM on December 10, 2011
Yeah, your risk from the activity is very very low. Your risk based on a true undetectable viral load (or really even a relatively low controlled viral load) is even lower.
/worked in HIV public health for years
posted by OmieWise at 9:32 AM on December 19, 2011
/worked in HIV public health for years
posted by OmieWise at 9:32 AM on December 19, 2011
« Older I hope not a leaden question... | I'm having a heck of a time accessing our exchange... Newer »
This thread is closed to new comments.
posted by Chaussette and the Pussy Cats at 12:36 PM on December 9, 2011 [16 favorites]