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Unprotected insertive anal sex?

Question: 

I had spontaneous insertive anal sex with a man today, I did not know him and I did not get any contact details. We used a condom at first, as I always make sure to carry one around with me in my bag just in case, but it snapped about half-way through, so I threw it away and we kept going for another few minutes. Once we finished I urinated about 20 minutes later as well as cleaning myself up with some water and then drying myself to make sure I was clean.

I'm uncircumcised, how likely is it that I would have gotten HIV from this, and what should I do?

Answer: 

Hi there, and thanks a lot for contacting the AIDS Vancouver Helpline with your HIV/AIDS related health information. You seem concerned about the possibility of HIV transmission occurring during an encounter. We're happy to answer this question for you.

First off, it's great you used a condom for your encounter. Condoms substantially reduce the risk of transmission of HIV and other STIs. Unfortunately, because the condom broke during your encounter this situation is classified as high risk. A high risk activity does not mean that HIV transmitted in this encounter, just that of the transmissions that have occurred, most have occurred through activities such as these. The fact that you cleaned yourself after your encounter does not reduce the risk of transfer occurring.

Because this activity is classified as high risk, we'd suggest you head to a clinic near you offering what is called post-exposure prophylaxis, or PEP. PEP is essentially an antiviral regimen offered to people that have had a high risk exposure to reduce the likelihood of transmission occurring. We don't know where you're located, unfortunately, but simply googling "sexual health clinic" in your area should return a few results. If not, any hospital would be able to assess your suitability for PEP. It's unfortunately also going to require a bit of a commitment from you. A PEP regimen is 1-month of taking medications. After the 1-month PEP regimen, you'll need to follow up with your physician for testing. Tests are usually not considered conclusive until 3-months post exposure, and this is unfortunately extended by 1-month if you've taken a PEP regimen. So you will not know your status conclusively until 4-months after this encounter.

Thanks for contacting the AIDS Vancouver Helpline with your question, we hope this has provided you with a bit of direction on what to do from here. If you have any further questions about any of this, we encourage you to submit another question.

Trevor

AIDS Vancouver Online Helpline
Private & Confidential