[Question #11911] Potentially Risky Encounter - HIV Risk
11 months ago
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Had a risky encounter with a female who has had multiple sexual encounters previously.
I am HIV-, her status is unknown.
We had vaginal sex with condom for a little under 30 seconds. The condom did not break - I put water in after to check for any leaks. Additionally, I made sure that no part of her vagina comes in direct contact with my penis.
I am circumsized if that makes a difference on the risk threshold.
I still have time to go through PEP so wanted to know what is the likelihood that my encounter could have led to a transmission?
11 months ago
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Additionally, given this encounter, do you see any value in testing other than absolute certainty?
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H. Hunter Handsfield, MD
11 months ago
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Welcome to the forum. Thank you for your confidence in our services.
You say nothing at all about your partner. A friend or co-worker? Sex worker? If a sex worker, would you classify her as an escort (i.e. expensive, with sexual encounters by appointment)? Brothel worker? Bar pick-up? Was condom protected vaginal sex the only exposure? (No oral or anal sex?) Are you in a geographic area where HIV is known be common in women like your partner?
If we assume the worst -- that she is a highly active sex worker who usually does not use condoms -- you still are at little if any risk of HIV. Even with no condom, the average transmission risk for a single episode of unprotected vaginal sex is under one chance in 2,000. With an intact condom in place the entire time of penetration, that risk is reduced at least 99%. That would make your chance of HIV 1 chance in 200,000. And even this assume she has HIV -- which probably she does not. Being circumcised slightly reduces your risk as well.
Decisions about PEP should only be made with local doctors or clinics who understand the situation in that area. But from all you say, I doubt PEP would be recommended in this situation.
I hope these comments are helpful. Let me know if anything isn't clear..
HHH, MD
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11 months ago
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Hi.
Sex worker / escort in Turkey. Ethnicity Russia. Expensive. Only interacts with condoms. I asked today about her HIV status and she said that tested regularly and it is negative.
The exposure was covered oral and covered vaginal throughout. No anal.
Thanks!
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H. Hunter Handsfield, MD
11 months ago
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Thanks for the additional info. Very nearly zero risk for HIV and all STDs. If I were in your situation, I would not be tested for anything and would continue unprotected sex with my wife without worry. I certainly would not consider PEP.---
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