Anonymous
Hello,

First off, thank you so much for providing the public with information. I really appreciate your time.

I am a gay male in my early twenties. I practice safe sex by limiting my number of sex partners, asking partners about hiv status and testing, always wearing condoms during anal sex, and testing for hiv/stds annually.

I had a question regarding pre-cum and hiv transmission. It seems that although I wear condoms during anal sex, there always seems to be the potential for pre-cum to be somewhere that I don't want it to be. For example, mutual masturbation and anal fingering presents the potential for precum to enter the anus. Frottage before putting on a condom posts the potential for precum to be on the rectum before sex. Or recently, a guy accidentally put on the condom on the wrong way at first, and then flipped it over. All three of these have happened to me and I'm concerned that I might be miscalculating my risk of acquiring hiv. Should I be concerned about small amounts of pre-cum or should I look at the larger picture and see protected sex as protected sex?

What is my risk level of acquiring hiv through these instances? And what is my overall risk level given that I have a very low number of partners, discuss hiv/stds with partners, wear condoms, and test regularly?

Thank you so much for your time! I really appreciate this service.

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Anonymous
Hi there,

Thank you for contacting our Helpline for HIV related information. We are happy to assist you.

First of all, great job for being aware of HIV risks and taking all the right steps to protect yourself, such as using condoms and getting tested regularly.

You are correct to be worried about pre-cum as an HIV risk, because this is a body fluid that can contain HIV. However, the risk usually refers to sexual intercourse without a condom, during which pre-cum can produce a risk even without ejaculation. This is why we warn people that any amount of unprotected sex is risky, regardless of the length of time. In your case, however, it seems that your main worries are masturbation, fingering, and dry humping, through which pre-cum may be present outside the body and then come into contact with your anus. HIV is a weak virus and cannot be transmitted after being exposed to the air, which is why it is mainly transmitted through unprotected sexual intercourse and needle sharing, during which it has airtight access to the mucous membranes or bloodstream. From what you described, it seems that pre-cum would have been exposed to the air before having a chance to come in contact with the anus, so this does not pose a risk.

Overall, you are at a *low risk* for HIV transmission. Sex with a condom is considered a low risk rather than no risk, but when condoms fail it is usually through improper use or removal, or when they break. Keep doing what you've been doing in terms of practising safe sex and getting tested regularly, as this is the best way to protect yourself!

I hope we have addressed you concerns. Feel free to contact us again if you have further questions.

Thank you,

Sandra,

AIDS Vancouver Helpline Volunteer
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