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Probability of HIV infection of 20 second insertion of the penis in an anus

Question: 

Five days ago I had sexual intercourse with a person who doesn't have any symptoms. I used condom during all the intercourse, but at a time I inserted the tip of my penis inside his anus for 10 to 20 seconds. We were both dry (no pre-cum on me and his anus was dry) so I am nervous if I could get infected. I don't have any symptoms or ever felt sick after it.

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of HIV acquisition following unprotected anal sex (insertion of the penis inside anus). From the information given, this scenario is determined to be High Risk (Evidence of transmission through these activities is the majority of cases of transmission). Anal sex is considered the highest-risk sexual behavior for HIV transmission.

Receptive/Insertive penetrative anal sex without protection is still considered to be a High Risk act, regardless of time spent in the act. Whether insertion was a matter of seconds or minutes, there was still a direct exposure to the mucous membranes, and thus risk for HIV transmission. The insertive partner is considered at risk because HIV can enter the body through the opening at the tip of the penis (or urethra); the foreskin if the penis isn’t circumcised; or small cuts, scratches, or open sores anywhere on the penis. Furthermore, insertion without presence of adequate lubrication (fluids) carries a potential risk of tearing the anal mucous membrane which further increases the risk of transmission.

You cannot rely on symptoms to tell whether you have HIV. The only way to know for sure if you have HIV is to get tested. The symptoms of HIV vary depending on the individual and what stage of the disease you are in: the early stage, the clinical latency stage, or AIDS (the late stage of HIV infection). About 40% to 90% of people have flu-like symptoms within 2-4 weeks after HIV infection [1] Other people do not feel sick at all during the early stages (seroconversion). However, if you think you may have been exposed to HIV, it is essential that you seek out your health care provider to explore biomedical protective options such as Post-exposure prophylaxis (PEP), by taking anti-retroviral medications (medicines to treat HIV) after being potentially exposed to HIV to prevent becoming infected. PEP should be used only in emergency situations and must be started within 72 hours after a possible exposure to HIV. When administered correctly, PEP is effective in preventing HIV.

In any further sexual circumstance, you can reduce the risk of HIV acquisition by:

1) Using condoms and lubrication.

2) PrEP (Pre-exposure prophylaxis): People who are HIV-negative and at very high risk for HIV can take daily medicine to prevent HIV. (PrEP), if taken consistently, can reduce the risk of getting HIV from sex by more than 90%.

Recommendation: Refer to Physician for HIV test.

Regards, AIDS Vancouver Helpline/Online, (Vardah)