Extremely stupid mistake - I had unprotected vaginal and anal sex with 4 different Nigerian csw's in Dubai over a 36 hour period. It was multiple exposures and lengthy, so the only way I'm getting out of this is pure luck or a miracle.  I tested exactly 11 days after it ended with PCR RNA for HIV 1 and it was not detectable.  Also, 2 days after the episode, I took prophylaxis of 2.5 grams Zithro plus 800 mg Cefixime. Today is exactly 19 days post incident.

Going through your posts, it seems 11 days is conclusive for PCR, so do I need to worry or test again?  What about HIV 2?  Also, what about other STDs and hepatitis, etc.  Can I resume unprotected sex with partner, or do I have to wait for additional testing and if so, what tests and when to take for an all clear?  The only thing I noticed was my glans and foreskin were swollen and red with some red spots (the redness and swelling was immediate and the spots on the glans maybe a few days later), but I do get fungal infections so attributed to that and applied bifanazole cream for 9 days and it went away. 

HIVRNAPCR tests taken 11 or more days after an encounter our inclusive. Some experts suggest follow up testing at 4 to 6 weeks with a fourth generation HIV test but in our experience, the PCR test tests are conclusive at 11 days or beyond. 

The antibiotics she took after your exposure would cure gonorrhea, chlamydia, and prevents syphilis if exposed.

Overall, it is unlikely that you acquired an STI through the exposures you described.   In my opinion, further testing, while always a personal choice, is optional.  I see no reason for you to abstain from unprotected sex with your regular partner.  EWH

Thank you for your reply. Just had a few follow up questions:

1.  I agree on the work visa, but these women were on a tourist visa which does not require testing.  They come and go on that to avoid residency requirements (actually it seems most CSWs here do it this way).  Does that change the view in any way or do the PCR RNA results trump everything?

2. The PCR RNA is for HIV 1 - does that mean there is still a risk for HIV 2 considering they are from Nigeria or would this test have picked it up regardless?

3. Would doing a HIV Duo at 21 days be of any value?  Or should I just accept the RNA results and move on and consider myself fortunate?

4. Would I need to test for any Hepatitis (A,B,C) due to this exposure, and if so, by when?  Am I missing any other STDs?

5. I have heard of drug resistant gonorrhoea and chlamydia - would the hight dose and combination I took ensure this is not an issue?

Thanks

2.  An HIVRNAPCR test would not detect HIV-2 however HIV-2 is rare and particularly rare in Nigeria. Your risk is minimal however if you wish to test for HIV-2, you need a test specifically for that purpose.

3.  A day 21 HIV duo test would add little to the results you already have.

4.  You risk for other STI such as gonorrhea and chlamydia is somewhat higher than your risk for HIV. There is a little risk for hepatitis. If you wish to test for gonorrhea and chlamydia a urine test at any time will give you accurate results. If you choose to test for syphilis, which is also unlikely, a blood test taken at 4 to 6 weeks will provide accurate results.

5.  While anabiotic resistance by gonorrhea is an increasing problem. It remains relatively uncommon. In if you were exposed to gonorrhea and had acquired the infection, the likelihood that the medicines you took would have cured. It are more than 95% effective.  

EWH

Just some last general questions please:

1. If in future I used condoms for vaginal sex but no condoms for insertive oral sex, is that 100% safe and would it mean I wouldn’t need to ever test and even if I do this with others I can continue to have unprotected sex with my partner without fear or risk of transmitting any type of STI?  

2.  If I tested a girl for hiv (duo) or even just antibodies and it was negative can I assume that for practical purposes she is hiv negative and can have unprotected sex?  Just trying to find out what can be done to ensure safety if planning unprotected sex. 

Thank you for all your help. I feel I dodged the bullet this time and will be more sensible going forward. 

Thanks. 

1.  Condoms are nearly 100% effective for preventing acquisition of the most common STIs- gonorrhea, chlamydia, trichamonas, as well as HIV as long as the are worn throughout and do not break.  They reduce the risk of syphilis and genital herpes over 60% bot are not perfect.  Receipt of oral sex is low but not no risk.  There are no proven cases of HIV that have been acquired from receipt of oral sex.  There is a low risk of acquiring gonorrhea and very low risks of acquiring syphilis or chlamydia through receipt of oral sex from and infected partner.  Remember however that most people do not have STIs.

2.  Partners with a negative duo test at the time of sex virtually never transmit HIV.  There is a slight risk that a partner with a negative HIV antibody test could be seroconverting and transmit infection but this is extraordinarily uncommon.

Again, sorry for the delay.  This thread is now complete.  EWH