[Question #9] HIV Risk Question (For Dr. Handsfield or Dr. Hook)
113 months ago
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H. Hunter Handsfield, MD
113 months ago
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Welcome to ASHA’s Ask the Expert forum. Thanks for your question.
It sounds possible the condom was in place as your penis withdrew, in which case protection against HIV probably was complete. But since you don’t know for sure, better to assume you were at risk.
Even if your partner had HIV, the average transmission risk for the male partner for a single episode of unprotected vaginal sex, if the woman has HIV, has been calculated at somewhere around 1 chance in 2,000. (That’s why many heterosexual spouses of HIV positive persons never catch the virus themselves — which perhaps you didn’t know.) And in this case, you know your partner is uninfected. Could she be in the window period? Sure — but the odds of that are extremely low. Since fewer than 1% of sex workers in the US have HIV (fewer than 1 in a thousand in many parts of the country), there is still far lower chance that any particular sex worker is in the window period. I would add that your partner apparently uses condoms with her clients, unless for some reason you think you were the exception. So the chance she has been exposed recently seems lower still.
As for the oral sex part of it, no worries. HIV is rarely if ever transmitted by oral sex: there has never been a reported, proved case oral to penis or by cunnlingus (oral-vaginal) in either direction.
All things considered, the chance you were exposed to HIV is extremely low, and the likelihood you were infected virtually zero. You probably should be tested yourself in a few weeks; I imagine the negative result will be more reassuring than anything I can say here. If you have a 4th generation (duo, combo) test — for both HIV antibody and p24 antigen — the result will be conclusive at 4 weeks. Or 6 weeks for a 3rd gen antibody test, even though official advice says 3 months.
Turning to other STDs, your risk is a lot higher than for HIV. Still low, but high enough to warrant testing. I recommend you have a urine test for gonorrhea and chlamydia (it’s been a week, so you can do it now), and a blood test for syphilis 6 weeks after the exposure. The chance of syphilis in this setting is extremely low, due to current rarity of heterosexually transmitted syphilis in most of the US. (Most cases currently are in men having sex with men.) But better safe than sorry!
I hope this has helped. Best wishes— HHH, MD
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113 months ago
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H. Hunter Handsfield, MD
113 months ago
|
113 months ago
|
H. Hunter Handsfield, MD
113 months ago
|