[Question #7419] Protected vaginal sex

4 months ago
Hello doctors, 
I hope all is well. 11/16 I had protected vaginal sex with an escort. The condom did not break and I did the water test on it to be sure as well. I was also wearing my underwear  to avoid any skin to skin contact. On 11/17 I had a Interstim stage one procedure done. This is done for my bladder issue and it involves about 3 incisions to be made on top of my buttock. I was giving BACTRIM for 5 days after the procedure. I also had another exposure on 11/4 with a condom breakage upon inserting. I was exposed for about a second or 2. On 11/21 I noticed a swollen lymph nodes in my groin area. I have never noticed a lymph node in my groin before.  Did any of my exposures lead to a possible HIV infection or any other STD? I had problem with my question that I purchased earlier. I placed the order and asked the question but it did not submit and marked it as complete. Order number 9534. 
Edward W. Hook M.D.
Edward W. Hook M.D.
4 months ago

Welcome to our Forum and thanks for your question.  I'll be glad to comment.  There are several elements to your question so I will break my reply up.  The bottom line however is that your risk for HIV and other STIs is very low and there is little reason to be concerned.

1.  Your 11/16 exposure was a no risk event.  Condoms are still the best means of preventing STI and HIV acquisition if a partner happens to be infected.

2.  Your interstim procedure in no way affects your risk for HIV or other STIs. 

3.  Your 11/4 exposure was low risk but if your partner was infected there is a small chance of infection.  Most people, even most commercial sex workers do not have STIs and even if your partner was infected, most exposures do not result in infection.  The brief duration of your exposure also reduces the risk for infection.  If i were you, I would have no concerns whatsoever and probably would not feel the need for testing.  If you are concerned, testing is easy to do.  Tests for the most common STIs, gonorrhea and chlamydia will be reliable at this time but test for HIV will be 99% reliable 4 weeks after the exposure and completely reliable at any time more than 6 weeks after exposure.

4.  The swollen node you have noted is a non-specific finding.  It does not suggest HIV and could be due to just about anything.  If it raises concern, testing as described above in no. 3 is the way to go.

Regarding your problem with the earlier post, I suggest you contact the ASHA forum site administrator.  They are very good about resolving these things.

I hope that this information is helpful.  If anything is unclear, please feel free to use your up to 2 follow-up questions for clarification.  EWH

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4 months ago
Hello Doctor, 
Thank you for your reply. The reason I mentioned the Interstim procedure is to see if it might be an infection at the incision sites that is causing the swollen lymph nodes.  So from your answer there is no chance of getting infected from my exposure on 11/16 which was the protected sex? I’m sorry for asking all of these questions but the swollen lymph node is what is making me so worried right now. 
Edward W. Hook M.D.
Edward W. Hook M.D.
4 months ago
Of course there is a possibility that infection of the incision is related to the lymph node swelling but only if the incision is red , swollen and tender.  If so, this would be a procedural problem, not an STI.  I suspect the is unlikely 
.
Correct regarding your 11/16 encounter.

No problem with the follow up questions.

EWH
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