I am a married man in a monogamous relationship, I had one indiscretion 4 years ago which brought me to the forum and to seek outside help, depressingly what brings me back is a similar event.

I am currently working in Vietnam, last week I got blackout drunk and was taken by a driver to a brothel, I had unprotected oral sex (receiving) and I believe protected vaginal sex. (I remember very little from the encounter but I thought I remembered feeling relieved that the FSW had condoms but don’t remember the act of putting it on, taking it off or discussing it.)

My guilt and anxiety has driven me down the internet rabbit hole again and I am reading there is a high rate of HIV in Vietnamese SW and their male clients. 

I return to the UK from working mid March, which will have been 4 weeks post exposure. If I am tested for all STD’s would you consider the matter closed, assuming I did wear a condom so not risk of HIV. Would you do any further testing at a later date, syphilis etc?

Do you have any insight into HIV in Vietnam?

HIV is not as common in Vietnam and Sheena think. Less than 1/2 of 1% of women living in Vietnam had HIV. While HIV rates are almost certainly higherr amongst commercial sex workers, the term “higgh” is a relative term and the majority of commercial sex workers in Vietnam do not have HIV.  Furthermore, HIV is harder to get that you may believe. There has never been a case in which a person has been proven to acquire HIV from receipt of unprotected oral sex from an untreated, infected person. In addition, less than one in 1000 unprotected vaginal exposures lead to infection.  In other words, even if your partner was infected and untreated, there is a greater than 99.9% chance that you would NOT have been infected. The odds are very much in your favor.

If you test for HIV and other STI‘s four weeks after your encounter, negative tests will be virtually conclusive. Over 99% of tests for HIV are positive by four weeks after acquisition of infection. We have never seen nor heard of a person who had a negative test at four weeks, who went on to become positive subsequently although it may occur very, very rarely.  If your tests are negative after 4 weeks, my advice would be to move forward without concern.  EWH 

Thank you for the prompt response. I just had a couple of follow up questions.

1; My wife is now considering coming to meet me in Asia for the first two weeks of March, so it will be 14-16 days after the incident but 2 weeks prior to be being tested. Would you generally advise we abstain from sex until I am tested given my risk?

2; I’ve developed a sore throat today, 3 days after potential exposure, I assume this is coincidental or could it be related to an STD? Perhaps something orally obtained? I don’t believe I performed oral sex but as I don’t remember the majority of the encounter I couldn’t be certain.

I will keep my third message to relay the results of my testing in March.

 

Thanks again

1; My wife is now considering coming to meet me in Asia for the first two weeks of March, so it will be 14-16 days after the incident but 2 weeks prior to be being tested. Would you generally advise we abstain from sex until I am tested given my risk?

This is a judgement call.  You should be able to get testing for gonorrhea and chlamydial infection in Asia and can anticipate accurate test results at any time more than 5 days after your exposure.  Your risk for these infections is substantially higher than your risk for HIV or syphilis.  If you are not tested, condoms may be advisable.

2; I’ve developed a sore throat today, 3 days after potential exposure, I assume this is coincidental or could it be related to an STD? Perhaps something orally obtained? I don’t believe I performed oral sex but as I don’t remember the majority of the encounter I couldn’t be certain.

This is a bit early for development of the ARS (recently acquired HIV) and most other STIs in the oral cavity are asymptomatic.  I anticipate that this is coincidental

Hope this helps.  EWH

The doctor did some tests, urine test was negative for both chlamydia/gonorrhoea.

He wouldn’t take blood for hiv/syphilis as only 9 days had passed but sold me a rapid test, negative at 12 days.

1; is the chlamydia/gonorrhoea test conclusive at 9 days?

2; at 12 days I assumed there was no value in the rapid blood test?

3; You mentioned 1:1000 infection risk (if no condom with positive partner).

Would this be higher if the woman was newly infected?

If I am infected, will I be more infectious for the next two weeks until tested?

I appreciate these are estimates and challenging to quantify.

Thank you again for this service!

1.  Yes

2.  Correct.  Your risk for syphilis is very, very low but testing will not be conclusive until 6 weeks following your exposure.  At that time the test to be done is a blood test

3.  Remember, the estimate I provided above was an estimate for UNPROTEECTED vaginal sex.  There was no known risk from receipt of oral sex.  Yes, the risk for infection would be somewhat higher if your partner had become infected within the recent past.  This scenario however is quite low.  In the unlikely event that you were infected, you would not be infectious if your test was negative. 

This concludes this thread.  I hope the information I have provided is useful.  Please don't worry.  EWH