On 8/14, I had an encounter at a strip club resulting in less than five minutes of protected vaginal sex. The stripper put the condom on me, and everything seemed normal. I was inebriated and don't recall the details after that to confirm if the condom stayed on the entire time. But logically, I can't understand why she would have removed the condom at any time, so for my lost memory's sake, I am assuming this was protected vaginal sex.

My questions:

1. How much risk is there here in this encounter, and what tests would you recommend I take?

a) if it was a protected encounter the entire time | b) if for some reason it was unprotected and I dont recall

2. At 21 full days from the encounter, on 9/4, I took a full 10 STD panel including a HIV RNA, and I am awaiting all of the results. 

3. My main concern, for some reason (despite the overwhelming statistics showing this is unlikely) is HSV-2. I see a large lack of faith here in the IGG tests on this site. So I am wondering, if the result after 21 days, is negative for IGG antibodies. Is that test and information even worth anything besides my peace of mind? Could you put a accuracy/percentage figure on that information at all?  

Thanks

Stopping at the first line, condom protected sex is very safe; and statistically it is very unlikely any particular strip club dancer has HIV (contrary to what you might have assumed) -- certainly less than a one percent chance, probably more like one chance in a thousand. To your specific questions:

1. Let's say there's indeed a 1% chance your strip club lady has HIV. Chance of transmission from a single episode of unprotected vaginal sex, if the female has HIV, estimated at one chance in 2,500. Condom effectiveness around 99%. With these numbers, your risk of having acquired HIV calculates as 0.01 x 0.0005 x 0.01 = 0.00000005. If I have counted the zeroes correctly, that 5 in 100 million, or one chance in 20 million you acquired HIV. That's your (a) answer. If the condom is deleted from the equation, 5 in a million, or one chance in 200,000; that's (b). Your actual risks are ten times lower if we use the probably more valid guesstimate of one chance in a thousand she has HIV.

2. The HIV RNA test is 100% conclusive any time beyond 11-12 days. Your result will be negative, which should end all worries.

3. Your risk of HSV2 is higher than for HIV, but still probably on the order one chance in tens of thousands. Add to that your lack of symptoms (penile blisters or sores) within a week and, like HIV, the chance becomes one in millions. In other words, don't worry about it! And for sure don't test again for HSV2 (assuming a negative result this time). Your comments about unreliability of the blood tests is exactly right, which is why no legitimate STD or herpes expert ever advises testing after a single sexual exposure.

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

HHH, MD

Thanks as always.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.