Dr Handsfield, I’m a super anxious about HIV. I have a very strong fear for HIV hence I don’t engage in sex outside my monogamous relationship. But I made a terrible mistake of having sex with a CSW in india 2 weeks ago. I’m NOT sure if it was completely protected. Semi dark room. She put condom on my penis but I didn’t check if it was correctly placed. She gave me oral then I kissed her vagina. She then turned on top inserted my penis in her vagina & we had sex. It lasted for 1-2 mins. When I took out, condom slipped inside her vagina and it was hanging out. I added water to ensure it didn’t break. I left home and was all good for a week, I even had sex with my wife. But from last week I’m worried to hell. My mind is asking so many questions.

1. Did she really PUT the condom or not as I didn’t check. And whether the condom was put in correctly or whether it slipped in the beginning and I might have had unprotected sex (when I took my penis out condom tip was inside her & the remaining part of condom along with circle was hanging out so high chance it was protected sex but my anxiety is disturbing me). 

2. Since the Condom slipped inside her, have I got exposed to hiv? Her fluids might have touched my penis while taking out. 

 3. Since I didn’t check whether the condom was placed properly it might have slipped earlier and I might have got exposed.

4. Her boobs were not soft and I felt her vagina was kind of wired shape hence I doubt whether she is transgender women. Would this increase the risk as I read transgenders have high hiv rate. I called up the agency several times and the guy said all their girls do monthly hiv test and the girl is happy to test again if I pay money. 

What are my odds? How high is the risk? Is testing warranted? 

I’m super worried and cursing myself to put my wife in danger for my bad actions. 

Please help me. I’m super scared of testing but got no choice. 

You are correct that transgender persons do have a somewhat higher HIV rate than other persons but still, most are not infected and even most unprotected encounters do not lead to infection.  If you have your partner tested and she is negative, then there is no risk that you were exposed.

In addition to my responses above.  It occurs to me that you may wish to be tested.  I note that the encounter occurred about wo weeks ago.  If that is the case, you could have yourself tested using an HIV RNA PCR test.  If such a test is negative any time more than 11 days following an exposure, you can be confident that you were not infected.

I hope that this information is helpful. EWH

1. Could you pls calculate the risk and advise what the odds are for this exposure?

2. Since this happened in Hyderabad India, (I live in Australia)how bad is HIV there. I presume it might be to too high in CSW in India. 

3. I was hoping you would reply to this as no risk exposure but since you said low risk I’m now worried. Is testing warranted medically? Or you suggesting testing for my own peace of mind? 

4. Before this I had a few vaginal sex encounters since 2021. 3 in a massage parlour and 1 in a brothel, all protected vaginal sex in Australia. 10 times vaginal sex all protected with a friend of mine in India in 2021. And I also had sex with a relative, she was 8-9 months pregnant (HIV negative for sure as she did her HIV test in 2nd trimester)and since there was no risk of pregnancy we had unprotected vaginal sex for about 10-12 times this was in India in 2021. Can you calculate risk of these encounters and advise the odds? I’m super worried as I have been having unprotected sex with my wife all the time. I would die of guilt if anything happens to her. Stupid me I shouldn’t have done this. 

5. Have you or Dr Handsfield witnessed HIV from exposures like these? 

6. How much should I be worried? 

You post shows you are worried. I suspect you are worried substantially more than you need to be.  

Hope this helps. EWH

I was initially only worried about condom slippage but as I was giving logical reasons to myself my anxiety started trigging with all these other questions. 

Since you suggested testing for reassurance and peace of mind but not warranted medically. I’ve decided to MOVE ON from this exposure without testing. Because I have serious anxiety history of HIV test. 

Last time about 4 years ago I did HIV test for unprotected oral sex and continued testing several times for reassurance. Then my anxiety started triggering questions like whether the needle was new or reused. Then I started worrying about sharp items. I was on anxiety and anti-depression treatment for 1 year because of this. For me testing WILL NEVER help it will in fact make my anxiety even worst. 

I’m going to move on and continue unprotected sex with my wife. 

Please let me know otherwise. Really appreciate your help. 

Thanks 

As you know, we provide up to three responses to each client's questions.  This is my 3rd response.  Therefore, this thread will be closed shortly without further responses.  Take care.  EWH