[Question #1290] I need your help, Mistake

95 months ago

Doctors Hello, last week I made the great mistake of going to a prostitute (ratio of HIV from prostitutes in Spain 2-3%, government rates). I am a man and she is a woman. We perform the following acts:

- Mutual Masturbation

- Mutual Oral Sex (Unprotected, no menstruation). I gave her cunnilingus only with my lips, without introducting my tongue into her vagina (20 sec-1 min).

- Anal and vaginal sex (with protection)

Note: My lips were dry and a little cracked. That day I cut some dry skin lip with my teeth, but never came blood (pressed to prove it), but the skin was not intact (4-6 mm in diameter the area without skin).

My questions are regarding HIV:

1) Can masturbation cause cervical mucus down (i read that they contain virus) and facilitate infection?

2) My peeled lips increase my risk of infection?

3) I am very scared because I have a girlfriend. Can I have sex with her or better wait for the test ?. If you were me, would you consider necessary to take the test?

Forgive me for my English. I’m 25 and very very terrified and I think that all the odds are against me.

H. Hunter Handsfield, MD

95 months ago

Bienvenido al foro y gracias por su pregunta.

National statistics on things like HIV prevalence is sex workers are always highly variable from one setting to another. In general, those at highest risk tend to be over studied, so the true rate of HIV infection in female sex workers in Spain probably is under 2-3%. In all western countries, escorts -- expensive sex workers by appointment -- tend to have very low rates of HIV, compared with brothel workers, bar pick-ups, etc.

Perhaps more important, you describe a low risk exposure. Congratulations for having only safe sex! Condoms work very well, so the vaginal and anal sex were low risk. And unprotected oral sex is safe sex: there are no proved cases of HIV transmission by cunnilingus or from oral to penile exposure. Dry or cracked lips make no known difference. Hand-genital contact, mutual masturbation, etc is zero risk for certain. Allt hings considered, this was a very low risk exposure and you don't even need HIV testing, except perhaps for reassurance purposes.

To your specific questions:

1) There are no known cases of HIV transmission by hand-genital contact, even when genital fluids are used for lubrication.

2) Kissing and oral sex almost never transmit HIV, even though billions of kissing and oral sex events have occurred among people with sore or cracked lips. That makes no significant difference in your low risk.

3) Given your fears, I recommend you be tested, even though the risk you were infected with HIV is virtually zero. The negative test result probably will reassure you more than my words. That doesn't mean I believe there was significant risk; I do not. Stricly for reassurance. In the meantime, if I were in your situation, I would continue unrprotected sex with my wife. But I'm not you and you'll have to make your own decision about whether to wait a few weeks until you can be tested.

I hope this information has been helpful. Let me know if there is anything you don't understand.

HHH, MD

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95 months ago

Gracias por su rápida y amable respuesta, de nuevo perdóneme por mi inglés.

Thank you for your reassurances words, I am seriously considering whether getting test or forget the issue and continue with my life. I guess symptoms will decide the answer, right now I feel perfectly (10 days), excepting an intermittent anxiety. I have talked to many doctors and experts Irving Salit (very low risk sitiation), Kimberly Ann Page (she believes cunnilingus is very low risk), Andy Velez (no risk), Sindisiwe Van Zyl (oral sex has no risk) and now you. As you can see I have upset many people and basically people believe that there is almost no risk.

Just a few more questions

1) Before I meant, if I masturbate to the woman (more fluid) and put my dry lips (without some skin, but without blood) could add more risk. My doctor thinks that if there is no bleeding or serious injury, that lack of skin must disregard. what do you think? How should a wound to be relevant?

2nd) I had no EDTs. I have read that have other EDTs favor contagion, which had me, she, or either?

3rd) She put a lot of artificial lubricant in her vagina does this matter?

If I forget the subject and in 8 years I detect hivsiempre I can throw myself to one of the trains of the company for which I work (do not worry it's just Spanish joke).

95 months ago

When I say lips skinned, I mean peeled lips (as no bleeding, I do not know if they can be understood as a wound). I did not know this word in your language, do not know if you understood me correctly.e

H. Hunter Handsfield, MD

95 months ago

As I said above, I recommend you be tested for HIV. The negative result probably will help you stop worrying.

This additional information does not change my opinions or advice. 1) I understood what you meant. Your doctor is correct. With no bleeding, your lips still had intact skin; only the superficial layer was gone and the remaining skin was an intact barrier to HIV. 2) I think you mean STDs (ETS en espanol). It is true that genital STDs like gonorrhea, chlamydia, or herpes increase the risk of HIV if exposed. But the exposure itself must be risky, and yours was not. 3) Lubrication makes no difference.

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95 months ago

Thank you very much for your reply. The truth is that I'm much calmer and I'm slowly getting my life back. The lip was what I cared and that you give the reason my doctor, is very relaxing. That day I made a mistake, that I will not commit. I have more questions to ask, you've already accomplished what I wanted was to relax my mind. Thank you very much for your answers. God bless you.

95 months ago

I have no more questions*

H. Hunter Handsfield, MD

95 months ago

Gracias por las gracias. Buena suerte y los mejores deseos a Ud. -- HHH, MD---