Getting Tested After Unprotected Sex

"I had unprotected anal sex. I was the bottom, and he didn't come inside. I just want to know the risk and if should I seek help? Should I take a HIV test? Any suggestions?"

Unprotected receptive anal sex carries the highest risk for getting HIV infection. HIV can be  found in pre-cum, the fluid that sometimes comes out before ejaculation, so even if the top does not ejaculate inside there is still a risk of infection. Some doctors estimate that the risk of infection during receptive anal sex is anywhere from 1 in 50 to 1 in 500 and might even be higher (1 in 20) in HIV-infected patients who have been infected very recently (acute HIV infection).

Bottoms can also get other STDs like rectal gonorrhea or rectal chlamydia where ejaculation is not necessary to spread infection.  

We recommend that sexually active MSM with multiple partners get HIV tested and STD testing at all exposed anatomic sites (throat/ anus) every 3 to 6 months.  Be sure when getting STD tests of the throat or rectum that DNA or molecular tests are used.  Those DNA/molecular tests are much more accurate than traditional culture tests.  Both require a doctor to use a swab to collect a sample inside the back of the throat or inside the rectum.  Major commercial laboratories like LabCorp and Quest Diagnostics now routinely offer those types of STD screening tests.

In addition, those with recent potential exposures to HIV should get an HIV test that includes HIV RNA screening.  HIV RNA screening is another DNA/molecular test that is much more accurate than a traditional HIV antibody test and can identify infection as soon as 7 days after exposure.

It is always a good idea to get tested for HIV and other STDs before having unprotected sex. However, this isn’t always realistic, so if you are nervous about your status, the best thing to do is come in for a test so you can know for sure. For more information on STD testing, visit http://dphwww.sfdph.org/sfcityclinic/ or STDTest.org (includes DNA/molecular testing and HIV RNA testing) for places in San Francisco or call the CDC National Hotline for services near you: 1-800-CDC-INFO.

For read more about HIV testing, see http://sfcityclinic.org/stdbasics/hivaids.asp.

To your health,
Dr. K

(Photo: Getty Images)

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Dr. K is Jeffrey D. Klausner, MD, MPH, a board-certified internist and infectious disease specialist. Currently, he is a deputy health officer and director of the STD Prevention and Control Services Section at the San Francisco Department of Public Health.

This information is for educational purposes only and is not intended to serve as medical advice. The information provided should not be used for diagnosing or treating a health problem or disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, you should consult your health care provider.

Comments

[harli]

okay so my dad thinks im having sex and is going to get me tested to see if i have had sex before can the doctor actually see if you have had sex before???

[Tony]

Harli,

No, a doctor can't tell if you've had sex or not with a simple test. What they can test for are sexually transmitted infections, such as herpes, HIV and others.