[Question #1806] Three meetings, one nightmare

42 months ago
Dear Doctor.

Last Sunday, I have 3 unprotected vaginal sexual relations with 3 differents prostitutes. I was drunked and I was influenced by drugs. However, I'm not sure if I penetrated them without a condom or if they feigned penetration as I was drunk and drugged.(I did not feel sensations of penetration in the vagina but finally I ejaculated). I want to assume that I penetrated them without a condom, and I want to know, what is my risk assuming prostitutes was HIV+ (I asked them and they said me we are HIV- but could lie me) and what kind of risk I have or if I am HIV+ already.
 
I am from Colombia.

Thanks a lot off.

Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Welcome to our Forum.  I'll be glad to comment?  In your situation it is best to assume that you did penetrate your partners and, for that reason, while it remains unlikely that you caught HIV or any other STI from your encounter, it would be best to test. You can test for Gonorrhea and Chlamydia at this time with a urine test.  For HIV testing it would be best to wait until 4 weeks after your exposure and then test with a 4th generation, combination HIV antigen/antibody test.  At that time the test results will be definitive.  You could test for Syphilis at the same, 4 week time.  WE do not recommend blood test for herpes in this situation and I would not worry about herpes unless you develop obvious genital sores.

Your risk for HIV is low.  The average risk of infection, if your partner was infected is between 1in 1000 and 1 in 2000.  Thus, even if all three partners were infected (unlikely) your risk is still less than 1 in 300.

I hope these comments are helpful.  EWH
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42 months ago
Thanks for your answer. 

Only this three question for final...

1) In my country laboratories generally have only 3rd generation test. When can I have a definitive result with 3rd generation test?

2) If I obtain HIV+ test. How much is my life expectancy with treatment, without treatment, side meds effects are devastating or can I have a normal life?

3) In your experience is frequently obtain a HIV + test with only 3 unprotected sexual encounters with HIV+ people (worst scenary) or have I still hope for be HIV-?

Thanks for all. 
42 months ago
Hello doc, I had pos + for  Gonorrhea, treated Azythromicine 2 gr one doze.  Can Increase the HIV Risk?

Thanks.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

To your questions first, then a further comment:

1.  Third generation tests provide conclusive results at  weeks.  at 6 weeks they are over 90% accurate.

2.  With modern treatment for HIV (which is unlikely in your situation), infected persons have a normal lifespan, requiring to take medications daily.  The medications are generally well tolerated.  Without treatment, most persons with HIV will progress to develop AIDs within 10-1 years.

3.  Given the circumstances of your exposure, I would estimate your risk for HIV as being less than 1/10th of 1%

2 grams of azithromycin will probably cure your gonorrhea but recommended therapy is to also receive an injection of ceftriaxone.  that you acquired gonorrhea is associated with a slight increase in risk for HIV but your statistical risk is still far less than 1%. 

I hope these comments are helpful.  EWH .


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42 months ago
Thanks doctor, today I take a Baseline HIV Test Negative and VDRL Negative. I have many fears with HIV and  I continue with Gonorrhea symptoms (except discharging) after 3 days of take Zythromax. My doctor give me ciprofloxacin 2 dozes each day for 3 days. I will expect the 6 weeks and 3 months test. Thanks for all.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

Just a final note.  there are strains of gonorrhea that are resistant to ciprofloxacin.  that is the reason that ceftriaxone, which I mentioned above, is the recommended treatment for gonorrhea.  If your symptoms persist after the ciprofloxacin, this could be the reason.

This is my third and therefor final reply to your questions.  this thread will be closed in a few hours.  Further questions will require a new post and additional charges.  EWH

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