[Question #11747] Razor cut on proximal of penis

12 months ago

Hello doctor

I wonder about my new situation. I shaved my dick and there was a small bleeding spot at the base of it. Then the bleeding stopped without doing anything. After 24 hours I had unprotected oral sex with a prostitute and protected vaginal sex with condom several times that night. What is my risk for sexually transmitted infections and HIV if she is infected?

H. Hunter Handsfield, MD

12 months ago

Welcome back, but I'm sorry you found it necessary.

The shaving cut makes no difference in your risk -- that is, the chance of any STI is the same as for any episode of condom protected vaginal sex and unprotected oral. Pay no attention to online statements about exposure of cuts or wounds to HIV, especially cuts that are not fresh and bleeding. A cut 24 hr earlier is already well sealed. If this partner is in the same brothel you described in your previous two questions, probably she is tested frequently and can be assumed to not have HIV, syphilis, gonorrhea or chlamydia. However, you could be tested for them if you prefer.

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

HHH, MD

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12 months ago

Actually, I had another serious worry that day. If I have sex with her without using a condom 2 times in the same day and ejaculate inside? What will my risks be? She told me that she had regular blood tests so I didn't have to worry. Do you suggest that single episode exposure does not require additional testing or PEP in this case?

H. Hunter Handsfield, MD

12 months ago

Unprotected sex (no condom) of course is higher risk. Given your partner's belief she doesn't have HIV or other STI lowers the risk, but of course is not a guarantee. Not knowing more about the likelihood of HIV and other STIs in CSWs in your setting, I cannot advise about PEP; a local expert would have to advise on that. Testing for gonorrhea/chlamydia in a few days and blood tests for HIV and syphilis in a few weeks might make sense, however. And of course I would advise you to always use condoms for such sexual events.---

12 months ago

Thank you very much for the answer.

I have confirmed from her that she works at a massage parlor in Thailand that has regular blood tests. She is tested every 2 months and the most recent test was 1 month ago and the result was negative. which is the same service center as before I'm quite comfortable now. I will be more mindful and careful so that this doesn't happen again.

H. Hunter Handsfield, MD

12 months ago

Good plan. It should include 100% condom use for vaginal or anal sex, no exceptions.

That concludes this thread. Best wishes to you.

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