Child! I know you’re scared, but first things first, take some deep breaths and relax.
Aunty Jimothy knows this subject inside and out. (ahem) Everything is going to be OK. That’s the first thing you need to understand.
You have nothing to be terrified of, but you need to do some things — right now, now waiting.
Blow your nose, will you? Here, I’ve got this ridiculous lavender polka-dot silk hankie that I was getting rid of anyway. It clashed with my pink feather boa. No, no, dear. Keep it. Really.
OK, what now? Let’s start with some basic information, but, please don’t be terrified of sex. That’s not healthy for you. First, the bad new. If your partner was HIV positive, then the kind of sex you had is the riskiest kind for HIV transmission. When a man is infected with HIV and he’s not in treatment, then his ejaculate may bear HIV in very significant quantities. Getting HIV is a real possibility.
But may I tell you a secret? The odds of your being infected with HIV from one encounter are very small.
Precautions are very important, because any time you have unprotected sex can be THE time you get HIV, but there’s no reason to panic.
So, the condom broke. You might have been exposed to HIV. What do you do?
Very simple. You get on a course of PEP.
Go to your doctor, to your county public health clinic, or to your university health clinic and talk to an HIV specialist about starting a course of PEP, which stands for Post-Exposure Prophylaxis. PEP is a pill you take once a day for 28 days that will prevent infection with HIV if you’ve already been exposed to HIV.
Don’t know who to call or how to get started?
Call the National AIDS hotline at 1–800–448-0440, or click the link below to find the right resources near you. If you aren’t in the US, type “AIDS hotline ‘your country’” into your search bar.
Last resort? Just walk into the nearest hospital emergency room.
PEP can prevent infection
According to the US CDC, PEP is highly effective at preventing HIV infection after sexual exposure, if you start it within 72 hours of exposure.
So that’s first, child. Go get that bottle of pills. Right now. Don’t worry about expense. If you can’t afford it, just say so. Your doctors will find a way to get you the medicine.
I’ve been there, done that. They really will! If you can’t afford it, swallow your pride and tell them, so they can help you.
OK, now that we’ve got that out of the way, what’s next?
Child, we need to talk. Let an old Aunty clue you in on a few things. If you’re going to be sexually active as a gay man, we need to talk basics.
First, good on you for using a condom! Very smart. Among men who have sex with men, receptive anal sex (a penis being inserted in your rectum) carries more risk of HIV transmission than any other kind of sex. Condoms are a terrific way to stay safe.
You need to know some things about condoms —
- The latex in condoms will break down if you store them in a hot place. Don’t put condoms in your wallet or on the dashboard of your car, for example. You’ll ruin them, and they’ll probably tear if you use them.
- The latex will also break down if you use a condom with Vaseline, hand lotion, or any other kind of oil-based lube. You need water-based lube like KY Jelly or Astroglide. Some specialty shops sell lube specifically designed for anal sex. You might prefer it, because it’s generally thicker and holds up better to a good … pounding.
- Condoms only work if you USE them. You must have them on hand whenever you think you might have sex. Keep them in the table beside your bed, in your backpack, book bag, wherever. And be aware that if you drink alcohol or do drugs, you may make bad choices. Something to think about. Aunty’s been there, done that too, child!
What if you don’t trust yourself to use condoms every time?
Even though the risk of HIV from any single sexual act is quite small, if you’re a man who has a lot of anal sex with other men, your risk could become very high over a period of time. Lots of receptive anal sex means you need to take serious precautions.
You might want to consider PrEP.
PrEP, or Pre-Exposure Prophylaxis, is a pill you take every day that will prevent HIV infection even if you’re exposed to HIV.
And get this. PrEP is even more effective than condoms — even if you forget a dose now and then. PrEP is so effective that at the International AIDS Conference in Amsterdam last year, papers were presented calling it nearly 100 percent effective in many cases. That position is controversial, but even the most conservative estimates rate effectiveness very, very high.
So, if you’re going to be having a lot of sex, maybe PrEP is for you. At least for a while. Only you can decide how much risk is acceptable and how likely you are to use condoms effectively every time you have sex. It’s worth thinking about carefully and talking about with a doctor who specializes in HIV.
Remember, using PrEP doesn’t mean you should stop using condoms! Other sexually transmitted infections can very serious, and PrEP can’t protect you from them. Hepatitis, for example, could ruin an otherwise fabulous day.
Oh, and one last thing, child.
I’m a little concerned that you worried about not knowing your sex partner. And not the way you’re thinking! Sex is wonderful. Aunty Jimothy has been there and done that. I’m not saying you shouldn’t meet a hot guy and have hot sex.
By all means. Ooh la la. What I’m saying is this:
You can’t know your partner’s status!
AS FAR AS HIV goes, it doesn’t matter if you know your partner or not. It doesn’t matter at all. Only you are responsible for your health. Anyone you have sex with might have HIV and not know they have it.
You need to be smart when you have sex whether you know your sex partner or not.
Got it? Good! Shall we sum up?
- Get on PEP right now, today, to prevent possible infection.
- Talk to your doctor about PreP to prevent future infection. Talk about how to get it at no cost if you can’t afford it. Many programs make that possible.
- Talk to your doctor about regular HIV testing, free if you can’t afford it.
- Get thee hence and have hot sex, my dear. Safer, smarter, hot sex, with condoms!
Don’t make Aunty Jimothy clutch her pearls.
That’s another Aunty Jimothy column on Medium, guys and girls. Got a question? Post it under this story or email firstname.lastname@example.org and she’ll do her best to crank out some pearlescent balls of wisdom.
By the way, I’ve got a whole bat cave full of lesbians, trans guys and girls, and kinky polyamorous bisexual chicks. So when you ask Aunty Jimothy, you’re tapping into a lot more than just Dame Edna’s cranky nemesis.
Ask anything! Love, sex, dating, hooking up, Tinder and Grindr culture, and HIV/STD concerns. Life with your straight family. Coming out. Or not.
This Old Aunty has the Answers. Somewhere. If I can just remember where I left my purse.