[Question #13815] HIV Risk unprotected sex with CSW
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8 days ago
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Hello,
I am male in 40s.
Last night after consuming far too much alcohol I stupidly had unprotected vaginal with sex worker. I am based in the UAE.
I am worried about all std risk and will go for a full set of tests in a couple of weeks but more immediately I am concerned about HIV risk. Given the exposure was approx 20 hours ago I believe that PEP could be an option. Earlier today I attended a clinic and asked about PEP but the doctor said their clinic couldn’t provide as only government run facilities can do so. He ordered blood tests for me for HIV. I questioned whether it was too soon to be valid as exposure was so recent. He said it wasn’t and proceeded with the tests. I would like to get your thoughts on this.
Was it too soon to test and therefore the result will be meaningless?
Should I continue trying to source PEP meds from another source given I am still within the 72 hour window?
Does the risk of HIV transmission increase substantially given it was with a casual sex worker as opposed to general population?
Thank you.
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Edward W. Hook M.D.
8 days ago
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Welcome to the Forum and thanks for your questions. I'll be glad to comment. This encounter was low risk for HIV and only slightly higher risk for other STIs. Rates of HIV and other STIs are relatively low in the UAE and most CSWs take precautions and/or get checked relatively regularly. The doctor whom you saw was incorrect, at less than 24 hours, no tests for STIs provide accurate information.
FYI IF your partner had untreated HIV, your risk for acquiring infection is less than 1 in 2000. In other words, in the unlikely circumstance that she had HIV, there is still a greater than 99.9% chance that you would NOT be infected. I would not encourage PEP with this low a risk. Your risk for other STIs is slightly higher but still low.
In terms of testing, a urine test for gonorrhea and chlamydia will provide accurate results any time more than 3-5 days after your exposure. Tests for syphilis and a 4th generation, combination HIV antigen/antibody test for HIV will not be conclusive until more than 6 weeks have passed. An HIV RNA PCR test will provide accurate information regarding HIV any time more than 11 days following your exposure.
The fastest way to find out whether you have been exposed or not is to contact this woman and offer to pay for her to be tested. If her tests are negative, you are not at risk.
I hope this information is helpful. If anything is unclear, you have up to 2 follow-up questions. EWH
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