[Question #11655] HIV

13 months ago

Hi, I hope you’re doing well. My question is regarding hiv transmission, about me, i am male, 30 years old, i live in Germany, in the past 03 years i had a dangerous lifestyle , i had many encounters with escorts in germany, but it was always protected, I have always used condoms, and i used to get tested every 04 months, the tests were always negative, so my last test was like 03 months ago and it was negative as well, after this test i had only one encounter with a Chinese escort in germany, it was only vaginal sex and protected with condom, the condom was worn all the time and didn’t break, the problem is that i had a pimple in the pubic area above my penis, the pimple was popped maybe one or two days before the encounter and i am not sure if it was 100% healed, I have no idea about the status of the escort, therefore my question is: if she was positive with Hiv and her fluids reach out to the pimple, is there a risk of transmission? Do i need to test ? I am asking because i met someone special and I decided to stop this risky lifestyle , and of course I don’t want to put her in any kind of danger, i hope you can give me an assessment of this situation, thank you so much for your efforts.

H. Hunter Handsfield, MD

13 months ago

Welcome to the forum.

I'll start with a comment you might find reassuring. You really do not describe a "dangerous" sexual lifestyle, especially as "escort" usually is defined -- that is, expensive female sex workers by appointment (in comparison with brothel workers, bar or street workers, etc). Such women typically understand the risks, use condoms regularly (as your partners have done), get tested frequently, and typically have low risk clients -- men like you. Certainly it is a good idea to be tested for HIV from time to time, as you have done (and also for common STIs, like gonorrhea, chlamydia and syphilis). But as you have found, usually those men consistently test negative. In other words, you describe a highly typical sexual lifestyle that really is not very high risk.

Can a pimple in the pubic area raise the risk? Probably not. Various online sources talk about skin wounds, cuts, etc as potentially elevating the chance of HIV, but if this is true, it's a very minor effect. If you think about it, pimples, folliculitis, and other skin defects are quite common in the pubic area and groin -- and still virtually no known HIV infection is situations like yours.

Since you're planning on a new and likely committed sexual relationship, I agree it makes sense to be tested at this time. Without those plans, I would not advise testing for HIV or other STIs at this time, but to just follow through with your regular testing plan, i.e 4-6 months after your previous negative test results.

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

HHH, MD

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13 months ago

Thank you for the answer, but to be honest the sex worker has offered me to do it without condom but i refused, that what makes me uncomfortable about the situation, if you were to give a percentage, how likely it is to get Hiv from this encounter?

H. Hunter Handsfield, MD

13 months ago

No higher than one chance in several million.---
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