It is correct that having HSV2 raises the risk of HIV if sexually exposed to it. However, I would emphasize "if sexually exposed". HIV is uncommon in most female sex workers, especially if you are in North America or western Europe, where well under 1% of CSWs have HIV (usually more like one in a thousand). Even if she has HIV, it remains unlikely you were infected. The risk of HIV in presence of HSV2 is roughly 3-4 times higher for newly acquired herpes, but lower than that (about double) for longstanding HSV2. "Double" and "four times" are not as big a deal as it first seems. Let's do a quick statistical exercise. If we assume the chance of HIV in your partner is 1% and transmission risk (if positive) 1 in 2,500, then without HSV2 your risk of HIV would have been 1 chance in 250,000. Double that is 1 chance in 125,000. Quadruple it gives 1 in 62,500. In other words, even with newly acquired HSV2, the odds are very much in your favor.

I'm not suggesting you ignore the risk; the statistical business is very rough, and in some circumstances the HIV risk could be a lot higher (e.g. if she has newly acquired HIV). If you are able to contact your partner, you could ask her to be tested for HIV (and perhaps offer to pay for it?); if negative, you'll know you were not at risk. Assuming that doesn't happen, you should be tested for HIV. In that case, I would advise you to find a doctor or clinic with experience in HIV treatment and prevention (as well as genital herpes) and follow his or her advice. Most likely it would include a nucleic acid test for HIV RNA at about 2 weeks:  a negative result at that time would be ~90% conclusive. And then antigen-antibody (AgAb, "4th generation") blood tests at around 4 and 6 weeks (98% and 100% conclusive, respectively).

Turning to your penile blisters:  I'm glad to see you are "being tested", but it should not simply be a blood test. You should be professionally evaluated in person to confirm whether or not you have herpes, likely with a PCR test to determine HSV1 versus HSV2, as well as evaluation for a new infection versus possible previous infection with a recurrent outbreak. Assuming a likely new infection, you also should be prescribed immediate treatment with an oral anti-HSV drug, i.e. acyclovir or valacyclovir. And if you contact your CSW partner about HIV, also inform her about perhaps acquiring genital herpes -- and the possibility you exposed her to herpes, if you have had it previously.

Finally, don't ignore other STDs. Having had unprotected sex with a CSW, it would be reasonable to have a chlamydia/gonorrhea urine test now, and a syphilis blood test in a few weeks. And I also hope you'll rethink condom use for future commercial sex events!

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

I'm awaiting a Dr's appointment but my HSV 2 is currently not fluid filled, just tiny red a few acne-like spots. I don't feel any pain so far. I couldn't seem to find any pictures online of what they might look like pre-blister stage. Would you happen to have any?

I'll be interested to hear more after you've had your medical appointment and have that provider's opinion.

Final q - in comparing it to dermatitis, would herpes usually be painful already pre-blister?

Normally threads are closed at this point, i.e. after two follow-up exchanges. I'll leave it open for a comment after you've been professionally evaluated -- but won't have more to say until then.