very concerned, an exposure opportunity

[alittleworried36]

Hi.  I am a gay man who had sex with another gay man, who i know - although not that well.  He did state that he was HIV Negative, tested first week of march AND wasnt in risky behavior since then.  But for some other reasons i am not sure i believe him.

here is what we did and my concern.
1.  he performed oral on me.  not worried here,
2.  I topped him with a condom and while there was some blood residue on condom, it seemed intact and i dont think it failed.  Not worried here.
3.  Before condom use, i super briefly entered with the head and maybe an inch  - for a second, truly noy longer, pulled out and put the condom on.  THIS IS MY WORRY.

question.  can u assess my risk?  i was trying to be careful and didnt hit all the marks, i know.  And now i am stressing out.  there are reasons i am not sure i believe his testing story, but who knows.  i just need to assume he might be positive.     From there, i am trying to understand theoretical risk from real risk.  Is ths it?  Should i DNA PCR or some other form of test?  I am very panicd.  i thought i did it all right, but i think now i am screwed this up.  

very scared.

thanks,
worried

[alittleworried36]

Thank you so much for this.  You have NO IDEA (or maybe you do) how much this helped.  I was FREAKING out.

WHEW

[H. Hunter Handsfield, M.D.]

Welcome back to the forum.

You had accurate replies from joggen and Lizzie Lou on the community forum.  I'll add my congratulations for your careful approach to safe sex -- consistent condom use for anal sex, discussing HIV status before sex (and presumably avoiding anal sex, or sex enitrely, with men who are HIV positive, don't know, or seem evasive about it).  By doing so, you can expect to go a lifetime without catching HIV.

As for brief "dipping", it would be best to avoid -- but given the brevity of the exposure and your partner's probably HIV status, this shouldn't be any worry for you.  Remember that with full unprotected anal sex, lasting for several minutes, the average HIV transmission rate from bottom to top (if bottom is infected) is around 1 in 500.  Even among men having sex with men, and even with anal sex, HIV is not efficiently transmitted.

From a risk assessment perspective, you don't need HIV testing.  Even for people with exposures much riskier than yours, I generally recommend against testing after any single exposure.  It is smarter to simply plan on routine HIV testing from time to time.  At your level of sexual safety, once every 1-2 years would be sufficient.  Of course you are free to be tested after this or any other individual exposure, and if you haven't been HIV tested in the past year or so, this would be a good time, since it's on your mind.  But not because of this particular exposure.

For sure you do not need DNA testing; a standard antibody test at 6-8 weeks (or a duo test for both antibody and p24 antigen at 4 weeks) is sufficient.  In the meantime, stay mellow.  There is no realistic chance you caught HIV.

I hope this helps.  Best wishes--  HHH, MD