I hope you've been well. I received a blowjob from a german provider in NYC who has been "escorting" since 2017. We had oral sex with a condom, vaginal sex with a condom, but I was not able to ejaculate with the condom. She/I we took the condom off where she proceeded to give me a handjob and than I finished the handjob with my hands. I have a couple of questions: would removing the condom/ her vaginal secretions be able to infect me with HIV(i am uncircumcised). I realize this seems like a very lowrisk encounter and decided to not get on PEP, however for piece of mind I would like to get tested. I have taken an rna aptiva (20 limit of detection) 5 days and 8 hours since that exposure, which I am still waiting for. I will also be getting tested 7 days and 8 hours as well and 9 days and 8 hours. How accurate would you say the HIV rna test will be 5,7 and 9 days? I know some studies state HIV rna test that are very sensitive can detect the virus as early as 5 days but do not offer any %.  

Thanks and I look forward to you. 

One thing I forgot to mention is that she seems like a very health concious provider, but she told me she has many hasidic jewish regular clients and I am sure she offers them extra services and I think they tend to have higher HIV rates than others in NYC? Any insight would be appreciated 

Please read my opening response to the question immediately before yours (no. 11674) -- which describes the lack of risk from any and all sexual contact except intercourse. There are no sexual practices that transmit HIV except those in which a penis enters another person's vagina, rectum or (rarely) mouth. And there has never been a scientifically proved case of HIV transmitted oral to penis. You were not at risk from the condom protected events described, or from the handjob afterward. I see no way you could become infected by the manner in which a condom is removed from the penis.

You cannot both take PEP and have meaningful HIV test results at the same time. These events definitely did not warrant PEP, you should not be using it, and I would disagree with any health care provider who prescribed it in this situation (assuming you did not exaggerate the exposure). But if you continue it, there is no point in getting tested for HIV until after you complete the 4 week course of treament. In that case, you can start testing a few days after your last dose, and have a conclusive antigen-antibody (AgAb, "4th generaion") blood test 6 weeks later.

How accurate is the HIV RNA test at 5-9 days? Without PEP, the test often is positive by 5-7 days (but I do not know the exact percentage) and nearly always (close to100%) by day 11-12. With PEP, a negative result is meaningless.

Sorry, but I have no knowledge about HIV rates in Hasidic jews in NYC or anywhere else. But overall the frequency of HIV is extremely low in "escorts", by which I mean expensive female sex workers by appointment. They usually care for their health, take precautions (e.g. condoms), get tested frequently, and have low risk clients (men like you).

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

HHH, MD