[Question #3665] Possible STI Exposure

Avatar photo
87 months ago
Hello-
While recently in Mexico, I had anal sex with a female sex worker(I am obviously male). I DID wear a condom, but it broke during intercourse. As soon as I realized the condom broke, I stopped anal intercourse and had oral intercourse to ejaculation. While I realize the risk of HIV and other STIs is low with insertion, could you please quantify my risk to HIV specifically and also other STIs? My exposure was 48 hours ago, does it make sense to pursue PEP given my circumstances? Thank you so much in advance for your service. 
Avatar photo
Edward W. Hook M.D.
87 months ago
Welcome to our forum. I would be glad to comment.  Given the location, the occupation of your partner  as well as your route of exposure, your risk for acquisition routine STIs (Gonorrhea, Chlamydia) ) is relatively high although by relatively high I would still estimate your overall risk is infection at being in the range of 1 to 2%.   Your risk for HIV is lower still.  At 48 hours the effectiness o PEP is low and I would not recommend this for you.

 Your risk for STI & AIDS is far higher than your risk for HIV. For peace of mind I would suggest some point more than three days after your exposure you seek testing for gonorrhea and chlamydia.    HIV testing is not conclusive until 4 to 6 weeks after your exposure. Finally in the absence of sores or lesions, we strongly recommend against blood tests for herpes  because the herpes blood tests are unreliable and have a higher rate of false positive test results. 

 I hope these comments are helpful to you. If there are further questions or provide up to you to follow up responses to clarifying or additional questions.  EWH
---
Avatar photo
87 months ago
I’m confused by your comment that my risk for STI and AIDS is far higher than my risk for HIV. How is it possible to have higher risk for AIDS than HIV? Isn’t HIV infection a pre-requisite to AIDS? Lastly, do you know the incidence rate of HIV infection when “giving” anal sex? I plan to get tested for all STIs as a result of this regardless. Thanks again.
Avatar photo
Edward W. Hook M.D.
87 months ago
Sorry, the inclusion of the words "and AIDS" was an auto-text error.  I meant to indicate that your risk for classical STIs was higher than your risk for HIV.  

IF your partner had HIV (statistically unlikely) the risk for acquisition on HIV is a little less than 1 in 100.  Thus I would estimate your statistical risk for HIV as being substantially lower that 0.1% (1 in 1000),

Again sorry for the typo.  EWH
---