[Question #2728] Is that situation a High HIV Risk ?

42 months ago
Hello doctor I'm 27 years old male Portuguese/Brazilian ( originally born in Rio , Brazil ) but now living in Europe in late June I meet in a online app a lot 19 y old Russian / Finish girl , we talk for two months before we meet in person in Helsinki, Finland on august 31 . I did this because I was living in celibacy since July 2013 ( 4 years ) due to OCD ( I have received effective treatment Zoloft ) so I tried to know as much as I could about the girl past sexual experiences, she confessed to me that she have beeing highly promíscuos on the past around the age of 16 and from 14 to 19 have had sex with around 30 mens she also mention to have had boyfriends from high risk European countries such as Estonia, Latvia , Ukraine and Russia but mostly of her sexual partners were from Finland although she said to like Estonian men before I meet with her I predicted that we would have sexual relations she did hiv abbot architect ag/ab the week before we meet and I did an oraquick oral swab on her before I have sex with her this test was also negative . The lab test ag/ab was made 8 weeks after her last unprotected exposure and oraquick 10 weeks I have had vaginal sex protected for around 30 times with her I keep the condoms for water test and I have heard a pop in one I used the lelo hex condoms they are made of hundreds of hexagons if it fails only one hexagon go exposed so it had one pin hole leaking water in 1 out of 30 condoms I think it fail due to my sexual inexperience. Can you tell me if me HIV risk was high ? Or if this tests can tell that the girl was not infected I'm very anxious I have had a sore throat and large lymph nodes in the neck that went away with antibiotic (azitromic)3 pills one per day . Sorry my English I'm also typing using my phone . 
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Welcome to our Forum.  I will be glad to comment.  The brief message I have for you is that you are not at risk for HIV from the exposure you describe but I worry that your OCD may make it hard for you to move forward.  I hope not. 

The details on the reasons I say this are:
1.  Even without testing most women do not have HIV, even women who may have had more than 30 partners some of whom were from Eastern Europe.
2.  That she had a negative antigen/antibody test a week before you had sex and a negative Oraquick test on the day you had sex provides very high assurance e that she was not HIV infected at the time you first had sex with her. 
3.  Your condom use will protect you from infection.  While the pinhole defect you describe may have slightly increased your risk for infection, the increment is miniscule if the condom did not break and you did not have other unprotected sex with her. 
4.  A sore throat with swollen lymph nodes is not a sign of HIV, particularly if it went away quickly with azithromycin.

Thus I would estimate that your risk for HIV or other STI from this exposure is so low that I see no reason for concern and no reason for testing.  I hope my comments will be reassuring to you. EWH 
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42 months ago
Thank you for your answer Doctor Hook , yes OCD is not easy have this situation happened 2 years ago I would have went completely crazy even with the most remote theoretical risk  fortunately now with treatment my OCD is under control and I'm having a normal live  in 2015 I have looked myself inside my house basically and was even afraid to eat in restaurants and use public bathrooms because of fear of HIV contamination as you can imagine .
If that helps you to give more details about my encounter and my partner I didn't have sexual relations with her for 30 times in a day but she was with me from august 31 to September 5 , I had brief anal sex with her for 20 seconds as she didn't like it and it was the first time I have done it in my life all penetrative sex was protected except for the litlee pin hole defect in the lelo hex condom I mention I have noticed a pop and  I changed this condom so I believe I was inside her for only couple seconds with that condom I also had couple seconds where I gave her cunnilingus once for 20 seconds  I stop because she had a secretion from I guess sexual excitement and the taste was not so good for me ( I'm not sexual
Experienced so. most man maybe would not fell ) she also gave me unprotected oral sex for maybe 5 times .
As for her beeing a Eastern European i don't know if that category applies fully to her ,her dad is Russian and mom Finish , she was born in Russia but have lived since age 5 in Finland so now for almost 15 years my fear was more because of her sexual past and relation with ex Estonian boyfriend, her big sexual experience is maybe not so high as she can have tried to impress me and I know she says good things about Estonia because she had a boyfriend there and he died hit by a car in march so Estonia probably have her good memories of a lost love . I guess all that information is irrelevant as the important part is that she have had 2 negative tests and one was a duo I know oraquick is not so accurate but also good . I took This tests in consideration when I decided to not run for the hospital in the day to ask for pep I know if i mention the test they would deny me pep even with complete unprotected sex . In 2012 I have took pep after have had sex with a Brazilian  Prostitute , i actually lied to the doctor and told him the condom broke but I was sure of that i was more afraid that the condom was provided by this women , i remember the doctor told me he thought the risk was very low and pep was up to me , I have had really bad side effects back then and wish I haven't took it . Since this I had 40 duo negative tests mostly for environmental OCD exposures but I have stopped testing in February 2016 now maybe you think why I have had so many testing to have sex with a girl that is promiscuous later unfortunately as you mind know I can't know who he promíscuos or not as most of woman just tell low numbers maybe 1 or 2 and also you will find very difficult to near impossible to test a woman to have sexual relations with them I got some refusals and some even got extreme offended when I ask for HIV testing I know that even my friends who are in relationships are afraid to ask and offend their girlfriends . I guess even with the condom defect I took the best approach to avoid HIV if you are aware of this new lelo hex condom they broken completely as other condoms as they are divided in hundred of sections of hexagons .
I don't know if my additional information would change you opinion at all but if you want to know any additional information that would help please let me know I didn't provide all thie information initially because the post are limited also about the symptoms i have had the girl also had similar symptoms but she had a fever this was likely caused because we have beeing walking late at night in the north of Europe and temperatures are here at night lower than 5 degree C or 40 F with some strong wind can have caused this on me and her . Again doctor  thank you for your time and assistance 
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Thanks for the additional information.  They in no way change my assessment of your (lack of) risk for HIV from the exposures you describe.  If you had seen me requesting PEP I would have refused to provide it and reiterate that your risk for HIV from this series of exposures is almost zero and nothing to worry about.

Your follow-up however is an example of the huge impact of OCD challenges to some of our clients.  I urge you to continue to get professional treatment for your OCD and wish you the best.  EWH
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42 months ago
Thanks for the answer again Doctor Hook , i know this is the last follow up and the end of this thread . I have a question that has beeing in my mind the last fell days and I know you going to say my OCD is getting the best out of me but I think ask won't be a problem .
When I was in the hotel with this girl she use to sleep with a dress and without underwear just beside me on the bed and I used shorts and no underwear . I happen to have frequent erections during my sleep ( I'm
Not sure why maybe because of years without sex )I also sleep very heavy ( which means is not easy to wake me up ) . 
In the unlikely event this woman have put my unprotected penis inside her vagina while i sleep my risk remains extremely low or increases drastically? 
I know this sounds an unrealistic scenario but she have told me that my penis was erected while I sleep and that was even possible for her to have sex with me while I'm sleeping now you going to say why this women will have unprotected sex with you also , she actually after two days with me  have told me as she got tested and I also show my tests to her if I want to not use "that " referring to condoms I declined telling her I was afraid of unwanted pregnancy and she said she's on the pill and her family have fertility problems her mom and her grandmother nobody gets pregnant easy but it was ok if I want to use condoms  . I actually have contact the girl by phone and she said that she was playing and she didn't have sex with me while I was sleeping anyway I believe but still have some doubts on my mind I have beeing researching the forum and even back your and Dr HHH replies on Medhelp and your answers about unprotected sex seems to be that the risk is more related to the group and area of the world you have sex with for example heterosexual sex in North American between white Americans is low risk but sex with someone from where HIV rates are much higher such sub sarahan Africa is of risk high and of course this is logical but on the perspective of this girl I can't really tell HIV rates in Nordic countries such as Finland are almost zero and even Russia that is beside it and have 1% HIV rate I guess this is more inside risk such as intravenous drug users and their sexual partners and this girls it's different as she is half Eastern European and half Nordic but to simplify my last doubt is if this unlikely situation of unprotected sex have happened during my sleep have happended would my HIV risk increase or remain the same maybe I'm just going to far and what it matters is that this  girls is almost for sure HIV negative as her tests show ? 
Thanks for the great job you do here and have a good weekend 
42 months ago
Hello Dr Hook I understand My last follow up is a litle far fetched But Its not as impossible as it sounds to have happened . When possible please send me a brief comment on this last follow up . Thanks 
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Sorry for the delayed response.  The scenario you describe is not at all realistic.  Most men get erections in their sleep so this tendency is normal.  On the other hand, if someone were to have sex with you while you were sleeping, I am confident that you would wake up. 

Further, with negative tests on the part of both yourself and your partner at around the time you had sex, there is no reason to even consider this unrealistic possibility.  You really need to accept that you did not get HIV or other STI at the time of the exposures than you mentioned. 

At this time my sincere recommendation for you is two-fold-
1.  Stay off the internet as it will surely worry you about things that are not real or even realistic.  The internet often misleads persons because statements made there are made out of context or, on other occasions, just plain wrong.

2.  Seek professional help for your OCD.  Clearly it is causing you to worry about things that you should not be worried about. 

As you point out, this is my third reply.  thus this thread will be closed later today.  Take care.,  EWH
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