[Question #1553] Risk of HSV/HIV ,Trimmer cut on the base of penis and protected vaginal sex

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92 months ago
I am 26 year old male in India.On 24 Dec, I had two small cuts while shaving my pubic region and had a small bleeding. The two cuts were on the base of the penis(backwards) and on the skin where scrotum and penis connect.I applied aftershave after 5 mins and then a moisturizer. I had protected sex ,after 2 hours after shaving, with a sex worker and the intercourse lasted for about 30 mins. I used the condom for whole duration but it didn't covered the region where I had cuts . Now I am worried because I believe there is a possibility that her vaginal fluid might be rubbed on the scratched region. I asked her whether she had any history of STI's for which she told me that she does not have based on the reasoning that she never had sex without condoms with anyone,not even with his boy friend. As far as I remember, I didn't see any lesion on the vagina.Now 25 Dec  I cant see any cut that I saw a day before. I cant believe her by her words. I want to know whether I  fall in low risk or high risk category for both HSV/HIV. Waiting for your response. Also please suggest when should I get tested for HSV /HIV.
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Edward W. Hook M.D.
92 months ago

Welcome to our Forum.  We get many questions of this sort and the answers are always the same.  First a few facts:

1.  Most commercial sex workers do not have STIs, including HIV. 

2. Even if they do, most exposures do not lead to infection.

3.  Condoms are the most effective way to prevent STIs.  Theoretically when a condom does not cover a part of the penis or genitals one might get an STI transmitted by skin to skin contact such as herpes or syphilis (but NOT HIV) but that risk is very, very tiny.

4.  There has never been a study or even a reported case in which the small cuts associated with pubic or genital shaving have led to or increased risk for HIV or any other STI.  Thus while this might be theoretically possible, the fact that this has occurred millions and millions of times and yet there is no evidence that shaving increases risk in any way. 

Based on all of these FACTS (not theory) and millions of observations I can assure you that there is no meaningful risk for HIV from the exposure you describe and virtually no risk for herpes.  There is no need for HIV testing related to t he events you describe.  As for herpes, we do not recommend testing unless you develop lesions in an exposed area in the next 5-9 days.  if this does not occur, be confident that you did not get herpes from this exposure.

My personal advice is that you should not be worried about this exposure, that no testing is needed and that you should move forward with no concern.  I hope that you will be able to do this.  EWH

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92 months ago
Dr. Hook,
Merry Christmas
First of all I would like to thank you warmly for your reply. I thought I wont get a reply as it is Christmas , but your reply has helped me, to much extend, to overcome my fears and anxiety and I deeply appreciate your efforts. I am keeping my finger crossed that all goes well in coming 10 days. I would like to request you to explain this small part "how most exposures does not lead to infections and how really one gets infected with such viruses". I read on the net that to be infected with such virus, the virus must be massaged deeply in the tissue. What tissue it refers to? Will this case be applicable to mine since my cut part was not covered and that part might be (not sure though, just thinking worst case scenario) in constant contact with vaginal fluid (outside the body not inside).Though I somewhere know that it didn't happened since her secretions weren't oozing out( as far as i remember), but there were many instances that I inserted my penis deep into her vagina.

Also I would like to ask what precautions that one should understand and take while having sex with a person of unknown status. There have been many theories & suggestions on the net that makes a person baffled and that leads to anxiety.I know its a topic too vast to discuss, but your inputs will be helpful for me to understand the real picture. I am single,who wants to experience his sex life but doesn't have any other means than paid sex. and such fears destroys my regular life.
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Edward W. Hook M.D.
92 months ago

Your follow-up question is repetitive.  As I told you, there is no demonstrated risk from an exposure of the sort you describe. 

The issue of massaged into tissue refers to the fact that infections are more likely when friction is present a rubs the virus (or bacteria) into the skin,.  This issue is not applicable to you. 

The best thing a person who wants to reduce his risk for HIV can do is to use a condom correctly for all penetrative sexual encounters.

EWH

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