I am a heterosexual male and i live in Vancouver,canada. I will share my whole experience with you.

I contacted an escort by using an online service. We had unprotected oral sex but the vaginal sex was protected. The only problem that is scaring me is that later I got to know that she was using coconut oil as a lube, the intercourse lasted for 7-8 minutes.i asked her if she was negative,she told me that he is fine, but i am not sure about that too and also she do bareback service too but asks for more money, i came to know this later, but i used protection. As she used coconut oil as a lube ,I am scared what if the condom broke, as far as I remember, there was no breakage in the condom and as I didn’t ejaculated,there was no way to verify that the condom break or not.

So my first concern is

1.her using coconut oil as a lube might have damaged the condom but I didn’t saw any leakage of break with my eyes,what would you say on that

It has been 3 months since that and i have been very paranoid, googled symptoms,started feeling my lymph nodes every 15-20 times a day to check if they are swollen or not and even one time i pressed something so hard in my neck that it started pain there. This is what I did in my enxiety.I didn’t get any visible symptoms from the last 3 months after the exposure, there was no fever nothing but got a sore throat last month but it cured in a week with antibiotics. I am doing well now but the anxiety is killing me , i am constantly trying to feeling for my lymph nodes in neck due to anxiety, I don’t know if they are swollen or not.

It has been 3 months now i have not tested yet but i am very afraid. Can you please give advice to me that how much risk i am in and what would you like to say on this.

It seems you misunderstand the effect of oil on latex condoms. They do not increase the risk of HIV or any other infection except by increasing the risk of overt breakage, which you would have noticed. If the condom remains intact, there is no problem at all -- no less effective than with a water based lubricant. So you probably were afforded fully effective protection. In addition, escorts -- which I define as expensive female sex workers by appointment, as opposed to brothel workers, street prostitutes, and so on -- generally are believed to be at low risk for STDs in general and extremely low risk for HIV. Thy care about and protect their health, their clients typically are low risk men (guys like you!), they take precautions like condoms, and they get tested frequently:  so your partner's statement she is disease free probably is accurate. Your partner's willingness to defer condoms at a cost might increase the chance she is infected, but probably not much.

I don't understand why ejaculation or not would make condom breakage more difficult to judge. If it wasn't broken wide open and hanging on your penis by the rim, it would seem you can be confident it didn't rupture. Finally, IF she has HIV (probably under one chance in a thousand) and IF sex were entirely unprotected, the estimated risk you would have caught HIV is around once for every 2,500 exposures.

Those comments pretty well cover your questions, but to be explicit:

Clearly the condom didn't rupture, so protection was complete. See comments above.

Checking lymph nodes or paying attention to symptoms is pointless. These are very unreliable indicators of HIV infection. You need to be tested to know for sure you were not infected. Stop looking for lymph nodes. (Any symptoms from a new HIV infection would have come and gone by now anyway. Onset of HIV symptoms is always within 2 weeks, and the symptoms are gone by 4-6 weeks. You're way beyond those intervals.

So as implied above, my advice is that you be tested for HIV. While you're at it, have a urine test for gonorrhea and chlamydia and a blood test for syphilis. You can expect all to be negative. I have zero patience for not being tested because of fear of the result. It's absolute BS. It isn't the test that gives someone HIV:  you have it or you don't, and if you do you have a responsibility to yourself, your family, and your future sex partner to know it. When people who fear testing finally do it, anxiety always declines, even if positive. The fear of the result is always more debilitating than the result itself.

So here is the deal:  Get tested, then return to the forum to let me know the result. Until then, I will have no further advice, at least nothing different than I have already said. In the meantimes ay relaxed:  all your tests will be negative.

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

HHH, MD

Yes, it is true that female to male HIV transmission is inefficient and uncommon. If a female has HIV, the average risk of HIV transmission to a male partner is estimated (by the US CDC) to be 1 chance in 2,500, even without a condom.

I do not recommend HIV testing because there is any risk. I suggest you consider testing if you will find the negative result reassuring. Many anxious persons are more reassured by negative test results than by professional opinion, no matter how expert. But I think you should seriously consider testing:  if you do not, I suspect you will continue to worry unnecessarily. But it's entirely up to you.

Threads are closed after two follow-up questions and replies, so you have one more coming. If you decide to test, wait until you have a result to post.

I have some further questions which i wanted to clear out

1.The female to male transmission of virus is harder than the other way around but still there are some cases of men getting it from women,have you ever encountered any men  who got hiv after insertive vaginal sex after one exposure or multiple exposures?I also read in one of the thread the virus level in vaginal fluid and blood is same, is that true?i have had sexual partners before this but always used protection and i am sure the protection was completely intact, just in this case i was worried.also DR.Hook said on one of his thread that men who have multiple sexual partners are always at risk for sti and hiv even after consistently using condom, what does he mean by this,does that increases the risk.

2. I also want to know about genital herpes, as i had unprotected oral sex , after how long the symptoms appear and what does the genital herpes warts looks like, does it appear in clusters or causes itching?how to identify them . 

Yes, in HIV infected women, HIV levels are similar in blood and vaginal fluids.

Obviously Dr. Hook is correct that men with multiple partners are always at risk for HIV and other STIs even if they consistently use condoms. But "consistently use" still allows for condom breakage, unintentional misuse, and maybe even rare case of HIV or STI transmission despite condoms. Both of us recommend that all people sexually active outside monogamous relationships be tested for HIV and STIs from time to time, regardless of 100% condom use.

2. Herpes is too complex for brief replies. Do some online research -- there are plenty of sources with details descriptions of herpes symptoms, what sores (not "warts") look like, and so on. You can start with the sponsor of this forum (www.ashasexualhealth.org) and CDC (www.cdc.gov/std).

That completes the two follow-up Q&As included with each question and so ends this thread. I hope the discussion has been helpful.