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unprotected sex without ejaculation

Posted: Jan 21, 2007

QUESTION:

Dear Doctors,

Is there any documented case of HIV transmission through unprotected anal sex without internal ejaculation: for example, if an HIV positive man penetrates his male partner but withdraws before ejaculation? Can HIV be transmitted just through pre-seminal liquid? Thanks


  

RESPONSE FROM:   

    Since HIV is found in seminal fluid (it's the same whether before or after ejaculation), it's possible to have HIV exposure without ejaculation.

    One note is since the risk of HIV infection is proportional to both the duration of exposure and quantity of virus in the body fluid. Hence, since pre-ejaculate is smaller in volume than the ejaculate, there is proportionately lower risk (though by no means none).

    In practical terms, I counsel my patients who engage in anal penetrative intercourse to use condoms- not just for prevention of HIV infection, but also to reduce the risk of other STDs, including, but certainly not limited to syphillis, gonorrhea, herpes, hepatitis or papiloma viruses. BY




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