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Ask Dr. K

I recently had sex with three people. I was a top once and a bottom twice. I didn't let any of them cum inside of me. All of them told me they were clean, but I have been reading more about HIV and I am really worried that I could be positive. What are the chances of me being positive?

You didn't mention if you wore condoms during any of the sexual encounters, but I will have to assume that you didn't. What you were relying on instead was withdrawal, or the top (inserter) pulling out before he came. The withdrawal method works poorly in heteros for pregnancy prevention and works poorly in men who have sex with men for HIV prevention. Sometimes there is pre-cum and sometimes you just donít know if a partner has cum or not.

Wearing condoms during anal intercourse prevents the spread of HIV and other STDs. Without a condom, you can decrease your risk if you are HIV negative by being a top instead of a bottom and by practicing oral sex. However, being a top and not cumming inside a partner during sex does not reduce the risk of getting HIV. Most tops get infected by rectal secretions.

Even though your partners may say they are "clean," there is no way to tell by sight and they may not know they have been infected. Most STDs, including HIV, are without symptoms. A recent CDC study showed that nearly 80% of young gay men who were positive had no idea they were infected. Sometimes people do have symptoms but don't associate them with an STD.

I urge you to see your local healthcare provider for STD and HIV testing today. If you're in San Francisco, you can find out clinic hours and services by going to, visit or use for syphilis testing.

To your health,
Dr. K

Last modified on Thursday, November 19, 2009.
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