[Question #1690] hiv risk

43 months ago
Hello, my question is regarding what I feel to be a risky exposure. On December 23rd I had sexual intercourse with a female friend who is single and claims she isn't into condom usage however she says she is not that much sexually active and only had unprotected sex with her previous two boyfriends, this is in Texas by the way. our sexual encounter was protected, however she was a bit dry and I kept stopping because I kept feeling the condom going up my shaft as if it was getting pulled by her dryness, uncovering about an inch of more of my penis, it never came completely off because I ejaculated in it outside of her and when I did it was on properly and all the way to the base of my shaft. The condom probably move up about 3 times during our sexual encounter which I would proceed to pull back down. I got home and properly washed, the next day I noticed I had a red bump on the side of my shaft about an inch up, which wouldve been unprotected, it seemed like an infected ingrown hair or a small red abscess. I don't recall having it the day before and if I did i probably didnt notice, it actually just disappeared yesterday which led me to believe that it was an infected hair follicle. 

1)I want to know if it was exposed to vaginal secretions or if it went inside the vagina was there any risk of contracting hiv if indeed she was positive?

2)about 2-3 weeks after the encounter I went to the doctor because one night I developed nausea and chills, next day diarrhea all day and a low fever of 37.3 about 99f and inflamed lower intestine with pain, which they said was a stomach infection, they gave me a shot and I woke up fine the next day but had diarrhea for the next two days.

3) I am married and my wife is pregnant, this was a terrible mistake I made and I dont want to put her in any danger, should I be worried or am I good since my urethra and head of penis were protected?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
Welcome to the forum. Thanks for your confidence in our services.

Your thrid question shows you know that condom protection against STDs transmitted through genital fluids, such as HIV, gonorrhea, chlamydia, and viral hepatitis, is considered complete as long as the head of the penis and urethral opening are covered throughout the exposure. That remains the expert consensus, and from your description, it seems likely this was the case. Further, the chance a partner like yours has HIV is almost zero, and HIV is almost never acquired in a single heterosexual vaginal or anal sex exposure. The chance you caught HIV are zero for all practical purposes. As for other STDs, the chances of gonorrhea or chlamydia are higher than for HIV, because both are more common than HIV and more easily transmitted. Still, the odds are very strongly in your favor.

With or without slippage, condoms provide less complete protection against infections transmitted by skin to skin contact like herpes, HPV and syphilis. We can dismiss syphilis: the chance your partner had syphilis is on the same order as HIV; the large majority of cases in the US these days are in men having sex with other men. We all get genital HPV, and any particular exposure does not significantly elevate that risk -- and most HPV infections are harmless and never diagnosed anyway. Herpes remains a slight risk, but also is uncommon for any single exposure. For entirely unprotected vaginal sex, the average transmission rate is roughly once for ever 1000 exposures, if one partner is infected with HSV2 -- and you give no reason to suspect your partner has genital herpes.

Those comments pretty well answer your questions, but to be explicit:

1) No realistic chance even if she had HIV, which almost certainly she does not.

2) These symptoms do not sound like acute HIV, which does not cause diarrhea as a main symptom; and acute HIV would not clear up in leas than 10-14 days, regardless of any injection treatment. I'm sure this illness had nothing to do with the sexual exposrue 2-3 weeks previously. If you have young kids at home, that's by far the most likely source of such a viral infection.

3) While I understand your concern, I really don't think you need be worried. Of course you are free to be tested if negative results will give you additional reassurance. If so, a urine gonorrhea/chlamydia test is valid any time; HIV 4th generation (antigen-antibody) testing is conclusive any time 4 or more weeks after exposure (i.e. now) ; and syphilis blood test at 6+ weeks, i.e. at the end of this week.

Another reassuring route would be to speak with your extramarital partner. For all you know, she may be equally concerned about STD/HIV risks from you as the other way around. Perhaps she would be interested in being tested. If negative, of course you are home free.

I hope this information has been helpful. Let me know if anything isn't clear.

HHH, MD
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43 months ago
Thanks DrHansfield, this is reassuring, I was mainly worried because I had what i thought to be an ingrown hair and it worries me that it might have been exposed or went into the vagina during intercourse and I dont know how raw or healed it was
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
43 months ago
That wouldn't matter one way or the other. Having superficial skin lesions in the genital area, especially ingrown hairs etc, do not significantly increase risk of HIV (or any other STD) if exposed.

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