Risk Assessment Needed Because Jerkoff kept taking off Condom

[MissEducated]

Hello,

I was directed to this site by a friend because I was so nervous about the situation I put myself into. I found two links that are similar to my risks.

http://www.medhelp.org/posts/HIV---Prevention/HIV-Transmission-from-Pre-Ejaculate/show/1670665  ;
http://www.medhelp.org/posts/HIV---Prevention/African-American-Epidemic--please-advise/show/717093

My boyfriend and I broke up for a 3 week period during the holiday break. I had sex with a acquaintance that I have know since childhood. I know he is a local bartender, he drinks, and  I believe he is straight, and he is Black and 42. I am 11 year younger and Black.

The first time we had sex was December 24, 2013:  Oral Sex, digital Sex, he attempted to penetrate me and I said no, not without a condom. He did as requested however, he took it off when he entered me from behind. It was about 5 minutes of unprotected exposure, no ejaculation. I stopped him and said, if you want to continue you will get a condom. He complied and we continued to have sex until I was tired.
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The second time was January 1, 2014: Oral Sex, digital sex and this time I put the condom on because I said, no I am not going to go crazy with worry. For the most part, the condom stayed on if I was on top because I could control the situation. Anytime we changed position he would take them off and it happened 3 times.  I would catch on. Brief unprotected 3-5 minutes each time. No ejaculation.

We finally stopped because he was getting annoyed that I demanded condoms and as long as he does not ejaculate in me, life is good and I got annoyed because I thought, what planet are you living on?

Listen, I had the STD, HIV talk because of our racial background and he swears he is clean and celibate. However he also said he gets tested every six months. (That is confusing)  He has been to jail for DUIs.

My boyfriend wants to get back together however I am anxious. Let me know if you agree that my paranoia is legitimate.

[H. Hunter Handsfield, M.D.]

Good to hear it.  Take care and stay safe.

[MissEducated]

Final Post:

Comfirmed today, the RPR was a false positive, confirmatory tests came back negative.

HIV, Chlamydia, and Gonorrhea, all negative. All in all, things are pretty good.

Thank you for you support and advice. I will be more adamant about condoms in the future.

[H. Hunter Handsfield, M.D.]

You may or may not have syphilis. A positive RPR test for syphilis requires confirmation; many positives are false, especially at low titers like 1:2.  A follow-up confirmatory test usually is automatic after a positive RPR, so it's probably in the works.  Let me know your confirmatory test result when available and we'll take it from there.

For sure your HIV test will be negative, and I expect the same for your gonorrhea and chlamydia tests as well.

[MissEducated]

Quick Update:

A few test results came back recently,

HEP B Panel- Immune, as I had the vaccine in elementary
Chronic Hepatitis B&C-Non Reactive
RPR- A and reactive, TITER 1:2. Does this mean I have syphilis?
No doctor has called this evening, I am not sure what to think. I am hoping this is a false positive.

No word yet on the HIV test, chlamydia or gonorrhea. I know I have taken 2 home access tests for HIV, that relieved a lot of anxiety, however, I did not think I would be at high risk for syphilis. I will keep you posted. I am going to the doctor again on Friday, the doctor is requesting another pap smear.

[H. Hunter Handsfield, M.D.]

I'm glad to hear of your negative test results so far (but not surprised); you can expect future tests to remain negative as well.

I agree the thread you found is a good one.  I'm glad you found it and sorry I didn't think to cite it myself in my initial reply.

[MissEducated]

p.s.

I found another link in the archives that discusses AA men and women and I truly agree with your theories about concurrency and the sharing of partners without the other person knowing. I had no idea how prolific it was until this incident. I have saved this link and the first two, too my favorites. If I am ever on the community site, these seem like quality links to share.

http://www.medhelp.org/posts/HIV---Prevention/Waiting-for-test-results-Cannot-take-it-any-more/show/1261996

[MissEducated]

Hello Doctor,

I took two oraquick In-Home HIV tests and they both showed negative results. It is roughly 35 days or 5 weeks after my last exposure, which was, January 1st, 2014.

I believe in past forums that is about 93-95% accurate. I am about to call my doctor to plan a date for a full- checkup. STDs, Women's Wellness, and BP and diabetes check.

You have said in the pas that you have no patience for people who refuse to test based on fear. I received my testing material in the mail today and rushed to take it.

I have that past partner in the dust because he refuses to adhere to the use of condoms. Hey, there are plenty of men who will respect that notion.

Thank you for your advice and I will keep you posted about the doctor's visit.

[H. Hunter Handsfield, M.D.]

This information doesn't change my opinion or advice.

[MissEducated]

Just a quick update on my situation.

I have just learned from my brother that the guy in question does use marijuana daily, cocaine on occasion and has possibly shot up a few times in the past, which raises my risk significantly.

I have made an appointment for planned parenthood this Thursday as I know you said drug use and injection drug use do raise the statistical risk of all STDs including HIV.

The only symptoms I have experienced are congestion, throat swelling as I do suffer from allergies and sinus infections, possibly swollen glands on the right side of neck and groin. I sound a little wheezy. As for my nether-regions, I had irritation because he was rather well-endowed and I had no legions or outbreaks that would point to HSV.

I only waited a little longer for an appointment as my period came on. I have talked to this man and he got pretty pissed off because he swears he is "ok." I only wrote an update to let you know that I am watching out for myself and I hope other women can read this and know that their health is their responsibility.

I slipped up and I pray I do not have something that I cannot cure.

I hope you are enjoying your January.

[H. Hunter Handsfield, M.D.]

I wish we could find a way to prioritize questions about legitimately worrisome exposures compared with anxiety driven ones about obvious low risk events.  But I don't know any way to do it.  I certainly agree that this and the STD forum are dominated by males.  In my experience, men are more prone to irrational anxieties about sex in general, and STD/HIV in particular, than women.  But there are plenty of exceptions; questions from hyper-anxious women certainly aren't rare!

Anyway, thanks for the thanks.  Take care and stay safe.

[MissEducated]

Thank you so much for the advice. I will just gear myself up to get tested and I will keep you posted about what the doctor says. I know based on your threads, I can get tested now for STI's and wait until the second week of February to get screened for HIV. I will hope for a negative result.

I am no mood to play the numbers game of 1 out of 1000 or 1 in 500. I took a risk, period. (I need to stay off the internet, I keep seeing stories about African American women were infected by male partners, usually zero condom use.) Still even with my condom use, it was not 100%, and a risk is a risk.  

I realize this may sound sexist, however, is there anyway in the future to create a queue for women who have had risky encounters. It seems like more men with low-risk encounters flood the queue.

I will stay off the site until I am tested.

Thank you for all your good work. I hope you had a wonderful holiday break.

[H. Hunter Handsfield, M.D.]

Your partner's condom removal was irresponsible, and also insensitive to your feelings, since he clearly knew that you wanted a condom to be used.  However, I cannot say whether this makes it more or less likely that he has HIV or may be at risk for it in the future.

Being AA does not itself increse risk of HIV or STD, and does not suggest you need PEP in this situation.  You and many other AA women are statistically at higher risk, but it remains in your control to keep that risk to a minimum by careful partner selection, consistent condom use outside guaranteed monogamous relationships, and until and unless you're in a mutually committed relationship, I would suggest period STD/HIV testing.  Better safe than sorry!

[MissEducated]

I apologize for the lack of clarity. I am a African American female and I was wondering if you saw any significant risks with the male acquaintance taking off the condom on 4 different occasions?

I may resume a relationship with my ex-boyfriend, who broke up me during the holiday break and changed his mind, however, I know I put myself at  risk having sex with another man that is blasé about condom use.

I wanted to see if my being African American and female raised the risk level for HIV and STIs, too the point where I need to get tested or even PEP.

I just want to do the mature thing in terms of my health and I hope this thread can help other women because I do not see too many posts from females.

Thank you

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for doing some research on your question by reading other threads.  You have found two that I often return to in response to questions from and about HIV risks in African Americans.

But to be honest, I don't see a specific question in all this.  If you're asking me to assess the riskiness of these particular exposures, or your overall risk as an African American woman (I think -- you never actually state your gender) dating AA partners, it seems to me you have done a pretty good job yourself.

Is your "paranoia" legitimate?  On one level, yes:  any particular AA male who has been sexually active with many partners is, statistically, more likely to have HIV than a similar white or Asian male.  That your partner has been in jail (briefly) probably doesn't mean much, however; the main risk that comes from the high rates of incarceration of AA men comes from sex or sharing of injection equipment in prison.

Having said all that, the specific sexual exposures you describe are mostly safe; HIV is not transmitted by kissing, oral sex, or fingering.  But you certainly are correct that condoms need to be used for vaginal or anal penetration, with or without ejaculation.

If you see this relationship as having a potential future, then I would recommend you and your partner both be tested at this time for HIV and other common STDs (gonorrhea, chlamydia, syphilis).  And discuss whether you're going to be mutually monogamous or not -- and if not, or if that isn't certain, use condoms!  And get tested for STDs and HIV from time to time.

I hope this has helped a bit.  Take care and stay safe--  HHH, MD