[Guest]

I recently had unprotected anal sex with someone that was HIV positive. I was not on the receiving end of this encounter, however I'm concerned about the risk factor's involved. I've been told that not being on the receiving end of unprotected anal sex reduces the chances of contracting HIV significantly. Is this true? Also, this person informed me that the virus is so low in his body after having taken the drugs to help his immune system that he no longer even tests positive for the virus. Incidentally, this person continues to take drugs for the virus. Additionally, while I realize continued unprotected sex with this person is not a good idea, what really are my chances in contracting the virus if I do continue to have sex with him?

[Guest]

On average, the chance of getting hiv from a single episode of insertive anal intercourse with a positive bottom is 1/1000. It's higher if their viral load is high, or if they have sores present or if you do. It's lower in the obverse situations. A person with a lower viral load is at lower risk of passing, but still has risk. The top person has a GREAT chance of getting hiv. The penis is an hiv magnet. The urethra as well as the indentation of the penis behind the head are RICH in hiv receptors. It is one of the great fallacies that only bottoms or women who engage in receptive intercourse are at risk.
Condoms are a drag, but they're nowhere near as much of a drag as having hiv and having to take mediciations once or twice a day, every day for the rest of your life, and never missing a dose.
Use condoms when inserting.
GR
[quote] I recently had unprotected anal sex with someone that was HIV positive. I was not on the receiving end of this encounter, however I'm concerned about the risk factor's involved... [/quote]

[Guest]

Thanks for the advise, doctor. I completely agree that in the very least, having HIV is a "drag"...and not even remotely comparable to the inconvenience of wearing a condom. I would suggest that it is perhaps a popular myth amongst the gay community that "tops" are at very low risk for contracting HIV through unprotected sex. I must admit that I've had several unprotected encounters due to the fact that I assumed I was at low risk since I am a "top". I will let my friends know that there is still a significant risk involved even if you are a top. On another note, I'm considering a relationship with this individual that is HIV positive with whom I had the uprotected encounter. My question is, what is the expected life span now of someone infected with HIV? He's had HIV for 10 years...but claims to be very healthy...and from what I can tell he seems quite healthy. As I stated before, he has told me that he is now "undetectible". Thanks in advance for your time.
[quote] On average, the chance of getting hiv from a single episode of insertive anal intercourse with a positive bottom is 1/1000. It's higher if their viral load is high, or if they have sores present or if you do... [/quote]

[Guest]

What most of us who work in HIV now think is that individuals who take their medicines correctly and maintain undetectable viral loads will have normal or near-normal lifespans. In Holyoke MA, we haven't had a single positive person on continuous therapy die of AIDS in over 5 years! That's amazing. Many other treatment cohorts report the same thing. In that group of treated folks I'm following we have had 7 deaths in that period: 1 heart attact, 1 pancreatitis, 5 cirrhosis from hep C. That's out of about 300 treated patients. Interestingly, we've got about 120 folks who won't take meds. They're too crazy, too drug addicted or too mistrustful to do it. In that group, we've had 37 deaths over 5 years, 32 of which have been from AIDS. Pretty convincing case for the value and safety of combination therapy.
Thanks for continuing to warn your friends of the risk of unprotected top. Incredible myths out there. How do these folks think HIV got spread from men to women and women to men in africa and asia, or from tops to bottoms and bottoms to tops here? If the passage is only one way, it would stop.
GR
[quote] Thanks for the advise, doctor. I completely agree that in the very least, having HIV is a "drag"... [/quote]

[Guest]

Gosh, what valuable insite you have provided. I'm sure you do this on a voluntary basis, so I wanted to let you know how grateful I am that you would take time out of your busy schedule to answer my questions. You are providing a very valuable service. Thanks again!
[quote] What most of us who work in HIV now think is that individuals who take their medicines correctly and maintain undetectable viral loads will have normal or near-normal lifespans. In Holyoke MA, we haven't had a single positive person on continuous therapy die of AIDS in over 5 years... [/quote]

[Ymorgan]

"How do these folks think HIV got spread from men to women and women to men in africa and asia, or from tops to bottoms and bottoms to tops here? If the passage is only one way, it would stop."

Well You do have some great advice! But the above statement is sort of wrong for many reasons....First it is way too assuming that there is a precise distinction between what one would call a "top" and a "bottom".....Research has proven that most GAY men are versatile, meaning they both act as the insertive and receptive partner in anal sex! Statistics also show that the receptive partner is much more likely to contract the virus because of many clear reasons like direct access to the bloodstream through the rectum, and the physics of anal intercourse and tear of the mucous membranes. Also, the probability is far greater due to the massive surface area of exposed mucous membranes compared to the small albeit significant membrane exposure through the urethra. Also natural protective mechanisms are put in place to prevent penile infections such as urination after ejaculation and circumcision.

This is not to make the argument that its not possible to contract HIV as the insertive partner, like the poster has stated, this has happens quite often. But the prevalence of HIV cannot be attributed primarily to this act, at least not nearly as much as receptive anal intercourse (with ejaculation) being the most riskiest... you are 10 times less likely to contract HIV by being the unprotected "top" than being the unprotected "bottom"...and even for the bottom its about 1 in 50 chance ( i think).