[Question #13518] HIV risk?

1 months ago

Had a brief sexual encounter with a sex worker it was protected. The condom didn’t come off. Am I at risk? Should I get tested.

H. Hunter Handsfield, MD

1 months ago

Welcome to the forum. Thank you for your confidence in our services.

You provide no information the nature of your sex worker partner (male? female? escort? brothel worker?) or where you are (country, city, etc -- which affect the chance she might have various STIs. You also say nothing about which infection(s) you are most concerned about (gonorrhea? chlamydia? syphilis? HIV?). Usually testing is not necessary or recommended after any single sexual exposure, even if not condom protected: most female sex workers have no transmissible STI; and even when infected, transmission often doesn't occur.

For those reasons, whether or not you are tested -- and for which infections -- is up to you. Your risk of infection probably was very low but not zero; sometimes there are unexplained condom failures. And condoms are inherently less effective against the STIs transmitted primarily by skin contact (like HPV, HSV and syphilis) than those transmitted primarily through genital fluids (like chlamydia, gonorrhea and HIV).

If you are nervous and would like the reassurance of knowing you have tested negative, you could have a urine gonorrhea/chlamydia test 4-5 days after the event; and blood tests for HIV and syphillis after 6 weeks. If you would like to provide more information about the situation and the STIs you are most concerned about, I might have additional advice. Let me know. In the meantime, I hope this information is helpful.

HHH, MD

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1 months ago

I visited a massage parlor a few days ago in the US. The worker there after the massage gave protected oral sex and then vaginal sex (female) both protected. Mostly concerned about HIV if testing is necessary and what are the risks levels overall for other stds

H. Hunter Handsfield, MD

1 months ago

Thanks for the additional information. It confirms your near zero risk for HIV and other STDs.

The large majority of sexually active women -- including sex workers -- do not have HIV, so your massage person probably isn't infected. Oral sex almost never transmits HIV, and condoms are highly effective in preventing transmission by vaginal sex. Your risk of HIV probably was under one chance in a few million. And your risk of other STDs also was very low.

So my advice above is unchanged: From a medical/risk standpoint, there is no need for testing. If somehow I were in your situation, I would not be tested and would continue unprotected sex with my wife without worry. But reassurance alone is a valid reason for testing. If being tested would help you worry less, feel free to do it; I've suggested the particular tests and their timing above.

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1 months ago

I did get tested for chlamydia and Gonorrhea 6 days post exposure and they were both negative. I’m experiencing painful urination. Can it be from another STI since these two were negative? Should I tested for others?

H. Hunter Handsfield, MD

1 months ago

Painful urination without visible discharge is not a common STI symptom. The nature of the pain also is important: mild or severe? Every time you urinate or only sometimes? With bladder pain or urgent urination? Your age also might be important: beyond age 40-50, prostate and bladder problems are increasingly common, can cause such symptoms either directly or by predisposing to non-STI urinary infections.

If penile discharge appears of course see a doctor or clinic right away. Or if painful urination continues a few more days without discharge. In that case, you can expect that the symptom is not caused by an infection from the exposure described.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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