[Question #10239] Unprotected vaginal sex

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24 months ago
I recently had unprotected vaginal sex with a woman approximately five times. 

Before we had sex, I'd requested, and she'd agreed, to get an HIV test. She reported she did get a test. 

Unfortunately, our relationship fell apart before she let me know about the results of her HIV test and I'm not comfortable asking now. 

I do know she has a very, very lengthy sexual history as well as a history of STI, including gonorrhea. 

If she'd reported a negative HIV test, I'd feel comfortable, but since I don't have access to her test results, I'm worried if I should consider PEP. 

The last time we had sex she was beginning her period and spotting (very light blood). 

Thank you!
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Edward W. Hook M.D.
24 months ago
Welcome to our forum. Thanks for your questions. I’ll be glad to comment. FYI, I happen to be on the form at the time. Your question arrived. Replies to any follow-up questions may take considerably longer. Before I do however, let me congratulate you on having discussed your and your partner’s sexual history and to have recommended testing for you both ( I presume) early on in your relationship. That is a great way to preserve your sexual health.

As far as the encounters you describe, despite your partner’s history of prior partners and prior STI’s this was a low risk event.  If you are located in North America, there is a far lower than 1% chance that she was infected with HIV. In addition, a single exposure to an untreated, HIV, infected partner leads to acquisition of infection, substantially less than once, and every thousand encounters. Therefore, in the unlikely event that your partner was infected, there is still a more than 99% chance that you would not be infected. That she was beginning her menses has no affect in the likelihood of infection.

If you were my patient, I would not be willing to prescribe post exposure prophylaxis for you. I hope this perspective is helpful. EWH. 
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24 months ago
Hi Dr. Hook! 

Thanks so much for your reply, it was very informative. 

I neglected to mention that the last time I had sex with this woman, I did not ejaculate.

I also had trimmed my pubic hair right before we had sex and had slightly nicked my leg. There was a small amount of blood. Is that sort of small nick a risk if her vaginal fluids contacted it? 

Thank you!
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Edward W. Hook M.D.
24 months ago
Thanks for the additional information however it does not change my assessment.  FYI, ejaculation does not seem to change the risk for HIV acquisition one way or another.

In addition, there is a wide spread misperception that shaving nicks or scrapes my increase risk for acquisition but in fact, they do not, even if genital secretions or blood do come into contact with the area.

Please don't worry.  EWH. 
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23 months ago
Hi Dr. Hook,

Thanks so much for your previous replies. I hope its OK if I ask a somewhat unrelated question. If not, please let me know and I'll purchase another question.

I woke up this morning to find that my scrotum, but not my penis, is covered with many small red dots. These small red dots, probably 25 of them, almost appear as if they are under the skin of my scrotum...they don't look like they have any height and they don't look like open sores at least that I can tell. 

I remember my scrotum being somewhat itchy last night, but I didn't think anything of it. My scrotum does not itch or otherwise hurt right now.

Portions of my scrotum with the red dots also looks a bit dry and reddish. 

I'm worried this might be some kind of STI, especially since I've continued to have unprotected sex with the woman from my original question a month ago. Our last unprotected sex was a few days ago. 

Does this sound like a STI? If this sounds like a concern, what is the best way for me to get the appropriate medical care?

Thank you for your guidance
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Edward W. Hook M.D.
22 months ago
The red dots that you mention do not sound like an STI.  The most common cause of redness and itching of the scrotum is fungal infections ("jock itch") which is not an STI.   Alternatively, if you have been putting anything on your scrotum, it could be a reaction to whatever you might be using.   If I were you I might try an over the counter antifungal cream (the kind women use for vaginal yeast infection).  If the rash gets worse or does not go away I, youmight have your doctor take a look but I would not be worried about an STI.

I see you posted the same question as a separate, new question.  I will close it without a response and suggest that you contact the site administrator for a refund of your posting fee.

This thread however will now be closed.  EWH
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