同志系列问答翻译2：分泌物是否感染
原文链接：http://www.medhelp.org/posts/HIV-Prevention/HIV-through-precum/show/757072 Dear Doc, I'm so worried, I think I'm starting tomake myself physically ill. Two days ago, I fooled around with a guy (my first)and I'm worried that I put myself at risk of contracting HIV, or any other STDfor that matter. Everything we did was safe: Kissing, mutual masturbation, andthen I decided that I wanted to try bottoming. He put on a condom, and ithonestly went in and out in a matter of 2 seconds, I couldn't take the pain.This doesn't sound bad but the thing I'm worried about it the transmission ofthe precum to the condom. When I was whacking him off, he had a considerableamount of precum but I also used lube with that. I can't really tell you howlong we did that for, maybe 10-15 minutes. That's when I decided to trybottoming. He put the condom on, and I rubbed lube on his penis (with condom)but I fear that precum was probably still present on my hand with the lube. So,I fear that precum was on the outside of the condom from my hand. Then, when Igot home, there was the slightest remnant of blood on my toliet paper. Youcould barely even see it, but it was there. I'm so worried. He didn't strike meas being infected, he had limited experience with guys and was way in thecloset. But that means nothing. I am going crazy, and I don't think I can survivethe 6 months it's going to take for anything to be 100% sure test wise. Whatare my chances of being infected? I don't know what to do. Sincerely, Craig 问：专家，我很担心。我想我是真的病了。两天前，我和一个男人出去鬼混（我第一次这样做），我担心使自己有感染HIV或其他性传播疾病的风险。我们做的所有事情都是安全的：亲吻，互相手淫，后来我想尝试一下肛交被动方。他戴了安全套，并插入大约两秒钟就出来了，我疼的受不了。听上去没什么问题，但我担心的是安全套里的射精前分泌物会造成感染。我给他手淫的时候，他分泌出大量液体，而且我还用了润滑剂。我真的不确定这种行为持续了多长时间，大概十到十五分钟吧。然后我就打算当肛交接受方了。他戴了套，我在他阴茎（戴着套）上抹了润滑剂，但我害怕当时抹润滑剂时沾上他阴茎上的射精前分泌物，然后又粘在套子上。回家上厕所后，发现厕纸上沾有一些血迹。不是很清楚，但确实有。我担心死了。他给我的感觉不像是感染者，也很少和人发生性关系，也并没有出柜。但这一点意义都没有。我要疯了，我觉得我撑不过六个月的时间。我感染的几率有多大？我不知道该怎么办了。
You are overthinking the risks out ofanxiety.Don't get hung up on minorthings like whether there might have been a little precum on the outside of acondom.The fact is simply that condomswork virtually 100% of the time.Ingeneral, it takes rather large amounts of virus exposure to catch HIV;"just one virus" doesn't do it. Look at it this way: if your partner had HIV, and if you were bottom,and there was no condom, and he ejaculated inside you, the average risk youcaught HIV was somewhere around 1 in 200. How high can it be with the minor potential exposure you are worriedabout? A little bleeding after a person's firstepisode of receptive anal sex doesn't sound at all surprising.The anus and rectum did not evolve as sexualorgans; over time, you will accommodate. In any case, the appearance of slight bleeding doesn't mean you were atheightened risk of catching HIV. You don't really need HIV testing at allafter this event.If having a negativetest will help calm your fears, feel free -- but you certainly don't need towait 6 months for reliable results.Anegative test at 6-8 weeks will prove with virtual certainty you didn't catchHIV. A final bit of advice, as you start on yoursexual career:You are on the righttrack to safe sex by using condoms for anal sex.But that's only part of the story.You also need to get in the habit of "doask, do tell":Never have sex withanother guy, even if safe sex is planned (condoms for anal sex, oral sex, handjobs, etc), without first asking about and sharing your own HIV status.Then avoid getting involved, or at leastavoid anal sex, with men who are positive, don't know, or seem evasive aboutit.Most people don't lie when askeddirectly.In the long run, "do ask,do tell" probably is just as important as condoms for anal sex.And just think how much less worried youwould be now if you had been reassured by your partner that he doesn't have it. Bottom lines (no pun intended):Please educate yourself about HIV risks andprevention.Get tested at 6-8 weeks ifyou'll sleep better with a negative test reuslt.In the meantime, kick back and relax; almostcertainly you weren't infected. Best wishes.Stay safe-- HHH, MD 答：
出于焦虑，你对风险想太多了。别老纠结于套子外面那点分泌物那种芝麻大点的事情。事实很简单：安全套几乎100%有效。一般来说，只有暴露在大量病毒中才能感染HIV；“仅仅一个病毒”是不可能感染的。这么说吧：如果对方是HIV感染者，如果你是肛交接受方，并且没有戴安全套，而且对方在你体内射精，感染HIV的平均风险大概1/200。那么你所担心的这种轻微潜在暴露的风险又能有多高呢？ 对于第一次接受肛交的人来说，出血一点都不奇怪，毕竟肛门与直肠并不是性器官。过一段时间就会好的。不管怎么样，轻微出血并不会增加HIV的感染风险。 单就这件事情来说，你完全不需要检测。如果检测结果阴性能够缓解你的恐惧的话，那么请自便，但你真的没必要为了这个可预见的结果焦急等待六个月。6到8周的检测阴性结果足以证明你并没有被感染。 因为你刚开始有性接触，所以最后给你一点建议。你已经有安全性jiao的意识，并且戴套肛交的好习惯。但这只是一部分。你一定要养成“问与说”的习惯。在性活动之前，一定要先询问对方是否为感染者或者告知对方自己是否为感染者，哪怕你们只是打算进行安全性接触（戴套肛交，口交，手淫之类）。如果对方是感染者，或者不清楚自己是否感染，或者对该问题闪烁其词的人，尽量避免和其进行性接触，至少要避免肛交行为。大多数人问起时都不会撒谎。长久来看，对于肛交来说，“问与说”也许和安全套一样重要。试想一下，如果你当时确认了对方不是感染者的话，现在不就轻松很多了吗？ 底线（没别的意思）：一定要学习HIV感染风险以及防护的知识。如果一个阴性结果能让你安心睡觉的话，6到8周去检测。同时，平静放松，你几乎不可能被感染。
I failed to mention that I did make a point to ask him if he was clean, and he said he was, although I'm not sure if he was tested negative. I do feel like I am over thinking this quite a bit, but the one thing I don't completely understand is how my bleeding doesn't put me anymore at risk. I'm assuming that I must've torn or irritated something when I inserted his penis, and from what I thought to be true, HIV is contracted through open cuts, etc. So, why am I not at high risk? Also, how long does HIV live outside of the body, for example, in precum? I've been looking it up on numerous sites and they're all saying different things. Sorry, this is the last question I'm going to ask. Thanks very much.
再问：
我还忘了说，我当时确实问他是否健康，他说是，虽然我不知道他是否检测阴性。我确实也觉得这次有点过度反应，但有一件事我完全不明白的是，为什么流血了还是没有风险？我觉得他插入的时候，我肯定什么地方发炎或者破损了。而且从我知道的情况来看，HIV是可以通过开放性伤口传染的。那我为什么风险不高？还有，体外HIV，比如说，在分泌物中，能存活多久？我查阅了很多网站，都有不同的观点。不好意思，这是我想问的最后一个问题。十分感谢。
Congratulations on asking about HIV status ahead of time.Of course people can lie, but most do not when asked directly.That your partner says he doesn't have HIV is strong evidence he isn't infected, although of course it falls short of proof.
Please heed my original advice to stop overthinking this.How long HIV can survive in body fluids is irrelevant; the fact is that people don't catch HIV through the sorts of exposures you describe.Most gay/bi men who catch HIV do so after months or years of repeatedly unsafe behavior, such as sex with anonmyous partners without condoms.That's not to say any single exposure cannot do it; of course it is possible and it sometimes happens.But it's unlikely.
HIV is much harder to transmit than you seem think.That's why I recommended you spend some time to educate yourself about the real risks. If you do that online, please stick with professional sites (like CDC and state or local health departments, or academic institutions) or with professionally moderated forums, like this one.
再答：
得知你提前会问起对方HIV感染情况我真为你高兴。当然，人是会撒谎，但大多数人直接问起时不会这么做。虽然他说的话缺乏证明，但你的性伴说没有感染，这已经是最好的证据了。
请听从我先前的建议，别再多虑了。体液中的HIV病毒能存活多久，这个问题和你的情况不相干；事实是，没人在你描述的这种情况下感染HIV。大多数的同性恋/双性恋感染上HIV都是因为长年累月重复不安全性行为，比如和不明情况的性伴进行无套性jiao或肛交。我并不是说一次无保护性行为就不会感染；一次就感染是有发生的可能性的，但可能性比较低。
HIV病毒比你想象的要更加难以传播。这也是我建议你花些时间去学习一下什么才是真正风险的原意。如果你想上网学习，那么请坚持查阅专业的网站（比如CDC，国家或者当地医疗部门，以及学术机构的网站等等）或者看一些专业制作的论坛，比如这个（指medhelp）。
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