Hello Doctors ..

First I want to thank you for the great job educating people to  get the right knowledge in the sexual health .

I really appreciate your tremendous efforts .

I'm not a native speaker , sorry for my poor English . Here is my story :

I'm a 28 years old male , circumcised .

I had incidence last 17 January .

I met a commercial sex worker from Russia  takes around 100 $ .She looks healthy as she mentioned no drink or smoking .

she said that importance of  using condom to protect herself from a disease .

We had  protected Sex , kissing, fingering .

 She opened the condom with her teeth " which I found it later  a wrong way to open " , anyway she put the condom in my penis and and starts

oral sex . Then , vaginal intercourse with same condom that takes around 5 mins "she used a water based lubricant in her vagina ".

after ejaculation , I left my penile organ inside her for a while and I lost my erection .Few mins , I took it out and I found  condom was covering half of my penis " the head is covered ". She removed the condom carefully .

 .After half an hour I took the condom and fill it with water to see whether has opening or no .I did not find holes .

my Qs

1- What is my risk assessment for Hiv in this event ?

2-Do mistakes that we made could reduce my safe measure in this event to get a safe sex ( opening condom with teeth , using the condom in two acts oral sex and vaginal sex , leave my penis inside after lost of erection " ?

3-Do I need Hiv test from this event ?

Thank you so much

The important things here are:  Even though sex workers in Russia have higher chance of HIV than in North America or western Europe, the large majority are not infected (as a guess, under 5%, maybe lower than that). Second, it sounds like your partner is pretty responsible about HIV/STD prevention, since she insisted on using a condom, so her risk probably is on the low side. Third, when a woman has HIV, the average transmission for a single episode of unprotected vaginal sex is less than 1 chance in in 1,000 -- and that's without a condom. Finally, with a properly used condom, the transmission chance is zero or close to it, if the condom remained in place and didn't break. It is normal for the condom to slip halfway down the penis; it doesn't reduce protection against HIV. (There was no need to check the condom for small leaks. If a condom doesn't break wide open in an obvious way, protection is complete.) The other details you describe really don't matter. There is no HIV risk from kissing, fingering, or other hand-genital contact.

Those comments pretty much answer questions 1 and 3, but to be explicit: 1) This exposure was zero risk for HIV. 2) You made no significant mistakes that would reduce condom effectiveness. As for testing (question 3), there certainly is no need based on this particular exposure. On the other hand, all non-monogamous sexually active people should be tested for HIV, syphilis, gonorrhea and chlamydia from time to time, so if you haven't been tested recently and have otherwise been sexually active, maybe this is the time, when it's on your mind. But definitely not because of this exposure.

I hope this has helped. Best wishes and stay safe--   HHH, MD

Thanks for reassuring me dr.Hunter

My best regards