On 14 th of April I had sex with a CSW Escort here in India. She charged me nearly equivalent of $200 in Indian Rupees.

I had protected sex with her using condoms (no breakage or cuts were seen as I checked for leakage after sex by filling water in the condoms and squeezing the water from condom's head, no leakage of water was seen, that is a relaxing thing for me to some extent) and had unprotected oral sex (licked her vagina for max 10-15 seconds) and I even spit the saliva outside also, I was unable to ejaculate due to the nervousness. Tried having sex with her 2 more times within 2 hours after initial attempt, yet was unable to cum, I guess I was very nervous.

My biggest fear is whether I am at risk by oral sex and penetrative sex? I know I made a mistake by cheating on my wife, but will this encounter be fatal for HIV and other infections?

I got in touch with the escort later after 2 days, she sent me Test results of her HIV 1&2, both negative from March 5 2024, but I can't believe her. I asked for new tests, she's denying for that.

When do I need to get tested for HIV RNA PCR and when to get tested for 4th gen antigen/antibody tests?

Please help doctors, my anxiety is killing me!!!

It's been 8 days since the exposure happened. Please help!!!

And after RNA PCR (10-14 days after exposure as in many questions here)and 4TH GEN ANTIGEN/ANTIBODY (45 days after exposure as in many questions here in the forum) tests, if they confirm negative, would it safe to say that I am not infected? Or should I wait for tests till 90 days? Or please tell me exactly when to get tested!

It is very unlikely you have been infected with HIV. Even before your CSW partner documented her recent HIV test results, it was statistically unlikely she was infected. In the extremely unlikely scenario that she has been exposed since those test results, there will was little if any risk:  with a condom, plus also perhaps only partial or brief vaginal penetration, the exposure was near zero risk. (However, your water testing of the condoms makes no difference and is not something we recommend. There is really no such thing as microscopic leaks that allow HIV/STI to pass through condoms. If a condom doesn't break wide open, protection is at its maximum.)

For those reasons, I would consider it entirely safe for you to continue unprotected sex with your wife. That's what I would do if somehow I were in your situation. On the other hand, if you feel you need the additional reassurance of a negative test result, a nearly 100% conclusive RNA PCR test can be done soon, i.e. 11-12 days after the exposure. As an option, you also could have a conclusive antigen-antibody (AgAb, 4th generation) blood test at 28 days. (The combination of negative RNA plus AgAb at 28 days is truly conclusive.) There is never a need to wait 90 days for conclusive testing; that's old news going back to older HIV tests no longer in use.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Please throw some light on this whether this is fatal for HIV Transmission?

3) According to your reply, I shall take RNA PCR after 11-12 days of exposure and if that yields a negative result, I need to take a 4th gen antigen/antibody test at 28 days, no need to wait till 90 days test, correct me if I understood wrong.

4) And I ask you again, with your experience Dr Hunter, I know I am anxious because of which I am asking you this question again, the acts that I performed are fatal for HIV transmission? I request you to please address me this, thanks a ton in advance!!!

2) Same for kissing:  few or no documented cases, extremely low risk if any.

3) "Need" for testing at all, and for a second (AgAb) test at 28 days, is your term, not mine. Your risk is low enough that I consider all testing optional. You may need it for reassurance, but not because of the risk level.

4) I don't understand "fatal". Do you mean certain transmission? Obviously not:  even with entirely unprotected sex, if a woman has untreated HIV, the risk to her male partner from a single episode of UNPROTECTED vaginal sex averages about 1 chance in 2,500. Some spouses of HIV infected persons never catch the virus themselves.

Sir, please guide me, are these tests enough to put my anxiety at rest or should I still need to get tested again at 45 days?

Having read enough answers from you people in the forum about same questions, yet I would still like to listen from you sir! Am I free of STD's? Your answer will personally calm me!!!

You don't describe any tests for STDs other than HIV; I have no way to answer that question, except to point out that your exposure was nearly zero risk for all STDs.