HIV Risks: A Guide for Urology Patients

Q: HIV Risks: A Guide for Urology Patients

Anonymous： Hello. 1. Contact with bodily fluids may lead to infection. 2. You need to first confirm whether the other person is HIV positive, as this will determine the subsequent steps. If you are unsure, treat them as if they are an HIV patient and take appr

Regarding HIV/AIDS

Hello Doctor: Recently, out of curiosity, I met up with someone I met online.
Upon meeting, the other person restrained me and asked me to perform oral sex.
During the oral sex, there was some pre-ejaculate fluid, but the other person did not ejaculate.
What is the risk of contracting HIV in this situation? Additionally, the other person repeatedly requested anal sex, but I refused due to not having a condom.
However, he still attempted to position himself on top of me.
Although there was no penetration, the glans of his penis did partially enter his anus (he claimed it did, but since there was no condom and no lubricant, it should have been very superficial).
In this scenario, is there a possibility of HIV infection? Afterward, we both masturbated, and I did not come into contact with his semen.
However, three to four days later, I started feeling unwell and went to the hospital, where I was diagnosed with gonorrhea.
When I asked the person I met about his status, he said he was fine.
Is it possible for someone to carry gonorrhea without showing symptoms? Lastly, is there a correlation between gonorrhea and HIV transmission? Thank you.
This was my first time acting so recklessly, and now I have gonorrhea.
I'm very worried about the possibility of also contracting HIV.
Thank you.

Niming, 20~29 year old female. Ask Date: 2015/06/03

Dr. Xu Weikai reply Urology

Anonymous: Hello.
1.
Contact with bodily fluids may lead to infection.
2.
You need to first confirm whether the other person is HIV positive, as this will determine the subsequent steps.
If you are unsure, treat them as if they are an HIV patient and take appropriate precautions, as well as follow-up treatment and testing.
It is recommended to get tested for HIV, Hepatitis B, and Syphilis three months later.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only be used as a reference; if necessary, you should seek medical care at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/06/03

More Info

Understanding HIV Risks: A Guide for Urology Patients
Thank you for your question regarding the risks of HIV transmission in the context of your recent sexual encounter. It's understandable to have concerns about sexually transmitted infections (STIs), especially when engaging in activities that may involve exposure to bodily fluids. Let's break down your situation and address your concerns.

1. Understanding HIV Transmission Risks
HIV (Human Immunodeficiency Virus) is primarily transmitted through three main routes: unprotected sexual intercourse (anal, vaginal, or oral), sharing needles, and from mother to child during childbirth or breastfeeding. In your case, the risk of HIV transmission through oral sex is generally considered to be lower compared to anal or vaginal intercourse, especially if there was no ejaculation involved. However, it is important to note that the presence of pre-ejaculate fluid (pre-cum) can still carry the virus if the partner is HIV positive.

2. Oral Sex and HIV Risk
During oral sex, the risk of HIV transmission is significantly lower than during anal or vaginal sex. However, if there are cuts or sores in the mouth, or if there is a presence of other STIs, the risk can increase. In your situation, since the partner did not ejaculate and you did not have any visible injuries in your mouth, the risk of contracting HIV from oral sex is relatively low, but not zero.

3. Anal Sex and HIV Risk
Regarding the attempted anal intercourse without protection, even if penetration was superficial, there is still a risk of HIV transmission. The rectal mucosa is thin and can be more susceptible to tears, which can facilitate the entry of the virus. If the partner is HIV positive, any contact, even if minimal, poses a risk.

4. Gonorrhea and HIV Correlation
You mentioned that you were diagnosed with gonorrhea after this encounter. Gonorrhea and other STIs can increase the risk of contracting HIV. This is because STIs can cause inflammation and sores, making it easier for the virus to enter the bloodstream. Additionally, having an STI can increase the viral load in an HIV-positive partner, further elevating the risk of transmission.

5. Asymptomatic Carriers of STIs
It is indeed possible for someone to carry gonorrhea or other STIs without showing symptoms. Many individuals may be asymptomatic, which means they can unknowingly transmit the infection to others. This is why regular STI screenings are crucial, especially after new sexual partners or unprotected encounters.

6. Next Steps and Recommendations
Given your concerns, it is essential to take the following steps:
- Get Tested for HIV: Since you had a potential exposure, it is advisable to get tested for HIV. The window period for accurate testing can vary, but testing at 3 months post-exposure is generally recommended for conclusive results.

- Consult a Healthcare Provider: Discuss your situation with a healthcare provider who can offer personalized advice and may recommend post-exposure prophylaxis (PEP) if you are within 72 hours of the exposure.

- Regular STI Screenings: Continue to have regular screenings for STIs, especially if you are sexually active with new partners.

- Practice Safe Sex: In the future, consider using condoms consistently and correctly to reduce the risk of STIs and HIV transmission.

Conclusion
While the risk of HIV transmission in your specific encounter may be low, it is not negligible. The presence of gonorrhea indicates a need for further evaluation and treatment. Always prioritize your sexual health by getting tested and practicing safe sex. If you have any further questions or concerns, do not hesitate to reach out to a healthcare professional for guidance.

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