[Question #5864] HIV + std risk

20 months ago
Dear Dr’s. ,

First of many thanks for creating an amazing forum that has brilliant and valuable information on STI’s. 

Unfortunately I’ve had a real mental and poor judgement. I live in the UAE and had a vaginal unprotected sex with a female chinese commercial sex and massage therapist. We’ve had sex twice and the exposure was about 2 mins per sex act. She has informed me that she is HIV negative as she’s had a test (not sure which one) about two months ago which was negative. She also said that she is free of other STI’s and that I should not be worried. 

Also after some research on the net and for precautionary reasons I have taken 2grams of Zithromax to make sure I’m free of the chlamydia,
gonorrhea, and Syphils. Im not sure if this is the responsible thing to do given my irresponsible act. 

My question what is the likelihood of being infected with hiv and other stis? Im panicking quite a bit and not sure what to do. Your guidance and support would be much appreciated. 

Thanks
 
Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
Welcome to our Forum and thanks for your confidence in our service.  It appears that you have looked at other posts on our site as well- thanks for this as well.  One of our goals is to make our replies available to others as a general information source.

As for your exposures. it was statistically a low risk exposure.  Most commercial sex workers do not have HIV or STIs (bad for business) and do get checked regularly.  In general STIs and HIV rates are low in the UAE.   Further, even if your partner had an STI, the risk for infection is low since most exposures to not lead to infection.  Infection rates vary from organism to organism but as examples, the risk for a man getting gonorrhea from a single vaginal exposure to an infected female is estimates to be less than 1 infection for 5 exposures.  For HIV the rate is far lower, 1 infection for more than 1200 exposures, if your partner was infected.

In general we discourage taking antibiotics in these situations.  Antibiotics themselves have side effects which can confuse things.  The medications you took would certainly cure chlamydia if present and cure much but not all syphilis and gonorrhea.  

So, what to do now?  You do not say how long ago your exposure was.  With the passage of time without the occurrence of symptoms, it becomes less and less likely that you were infected.  Having said that, all STIs can occasionally be asymptomatic so the best course of action for you at this time is to get tested.  Again, test reliability varies with the interval since exposure.  If you can tell me how long ago you were exposed, I can tell you when to test to be sure and to completely rule out the already very low possibility that you acquired any STI (including HIV) from your exposures.  

I hope this helps.  I look forward to providing a bit more information when I learn how long ago your exposure was.  EWH
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20 months ago
Many thanks for the reply , Dr. Hook. Unfortunately the exposure was two days ago and to be honest the internet is only increasing the anxiety. Just as a follow up question, in your entire career have you had any males test positive from similar episodes to mine or perhaps a one night stand with unprotected vaginal intercourse? Much obliged. 
Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
After an exposure two days ago, tests for gonorrhea and chlamydia will be reliable.  Blood tests for HIV will take longer- at 4 weeks 99+% of HIV infections will be detected by a 4th generation, combination HIV antigen/antibody test.  At that time a syphilis test will be conclusive for you as well.  My sense is that it is unlikely that you were infected or even exposed but you may want to test to be completely sure.  I wouldn't worry too much in the interval.

The other, perhaps best suggestion that I can make for you is to stay off the internet.  Unfortunately, much of what is to be found there is out of date, taken out of context, or just plain wrong.  It is hard to tell which is which- I urge you to avoid the internet.  EWH
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20 months ago
Many thanks again for your help Dr. Hook. I will definitely stay off the internet as it’s only causing further panic. I’m planning to pass by the STI clinic at the one month interval to conduct all relevant tests.  
Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
sounds like just the right way to move forward.  Good plan.  EWH---