[Question #10270] Protected Vaginal Sex with Sex Worker
 |
24 months ago
|
Hello,As I described at the subject I had vaginal sex with a paid sex worker while i was wearing the condom in Turkey. It was a expensive Russian Escort that she claimed she never have sex without protection and I'm circumsized. So we had some kissing, little bit of handjob then i had put the condom, rolled down but it felt like stuck and didn't roll down so before starting i opened another one check the correct side to be sure and rolled down. I think maybe last 1-2 cm of my penis at the bottom was not covered, 95% covered by condom. So there was penetrative vaginal sex around 10-15 minutes while i was standing and she was on the bed. I also used lubricant to prevent condom to break. When I'm done, i carefully dried the condom and around my penis with napkin just briefly and with napkin again i pulled it off. Like around an hour later since i was sort of paranoid, i took out the condom from top of the trashcan and filled it with water, there wasn't any leakage. So my questions are:1. What is the possibility of having hiv with this scenario? 2. After touching her vagina i have touched my penis to wear to condom, i don't think it was right after but let's assume so, would that be a risk? 3. I have pain below the foreskin which is sewed to below of my penis had to due to the circumsition. And it seems like there are very thin red veins where it hurts. Although this was there before this intercourse for couple of months, i thought it was gone but hurts again after handjob and vaginal intercourse. I had a blood test against all stds around 2.5 half months ago which is called Elisa test and they were all clean. Although i did no go to a dermatologist or urologist to talk about this pain since i thought it could be from just a rough sex back on that time and it would go away but it didn't. Could this be balantis? And could this be increase the risk of catching hiv?
|
24 months ago
|
4. When should i be get tested or should i get tested?
5. This happened around 10 hours ago, should i start on pep?
6. I have a girlfriend soon to visit, should i wait until I get tested before we have anything?
7. How paranoid am I do you think? I mean if the risk is that high that i should be paranoid?
Thanks for your patience and answer
 |
H. Hunter Handsfield, MD
24 months ago
|
Welcome back to the forum.
---
---
You provide a great deal of detail about this exposure -- so much so that it suggests you are overthinking the potential risks. Most of these details make no significant difference in STD risk. The important things are not how the condom is applied, what touching occurs during the process, and so on; the important aspect is that during vaginal sex, the condom is in place and well covers the meatus (urethral opening) and head of the penis, as well as most of the shaft. (Probably most exposures don't cover the penis as much as 95%; probably 80-90% is usual.) Further, you went about the exposure with additional safety, including lubricant to reduce the chance of condom breakage. It is an urban myth that condoms have microscopic pores or can develop small leaks that permit infected fluids to pass; if it doesn't obviously break wide open, protection is complete. For those reasons, examining the condom after use or the "water test" are unnecessary. To your specific questions:
1. You are near zero risk for HIV from this event, even if your partner is infected -- which probably she is not.
2. It is nearly impossible to have sex without some amount of touching of the sort you describe. It does not create any significant risk.
3. See below about your pain.
4. I do not recommend any testing on account of this event. But if you feel you must be tested for the reassurance of negative test results, you could have a urine gonorrhea/chlamydia test after 4-5 days and HIV and syphilis blood tests at 6 weeks.
5. PEP decisions are in the hands of local health care providers who understand the risks and probabilities in that area. Given condom protection, I doubt PEP would be recommended. If somehow I were in your situation, I would not seek PEP.
6. I see no need to hold off on sex with your girlfriend.
7. I'm not a psychologist and would not necessarily call your concerns "paranoid". But you appear to be more worried about HIV (and perhaps other STDs) than this situation seems to warrant.
Going to your penile pain, no STD causes the sort of discomfort you report. As you seem to suspect yourself, most likely it's related to your penile anatomy which was affected by your childhood circumcision. For confirmation, consider seeing a urologist. It could be that a minor procedure, with local anesthesia, would correct the problem. Good luck with it.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
---