Blood on penis from prostitute..hiv chance?

[notasmartguy289]

I am circumsized. I was tested tuesday 6/11 for every STD all negative. I have never had a STD unless mono counts.

I just had unprotected vaginal sex with a prostitute. I told her I had been tested last week negative and asked if bb is cool and said its okay. I am not sure if she would have done bb without showing her the results or not. When she came into my room i brought them up again and she asked to see them.

Anyway it took maybe 30-45 seconds to penetrate her then about a minute later i finished. i pulled out we talked for maybe a minute or two then i saw all the blood. I went to the bathroom, urinated and gently washed my penis with soap and water, did not scrub, then urinated some more. Then I stood in front of a very powerful oscillating fan and let my penis dry out completely for 3 or 4 minutes while holding the foreskin back so it was all exposed.

Maybe 20 min after she left I washed my penis with rubbing alcohol very briefly and warm/hot water, then hydrogen peroxide. Again no scrubbing and air dry.

This girl said she was clean while she was here and I asked her a couple of times. She said she tests every 3 months but kind of sounds like bs. Then i got really worried when i called her because i was worried about the blood and she wouldnt let me talk about it or ask about and now she wont answer the phone.

I am so stupid for all of this. What are the chances Ill have HIV from this?

[Edward W Hook, MD]

Your question relates to the way HIV infection starts.  As I said above, that you had blood on your penis does not increase your risk for getting HIV in the unlikely circumstance that your partner had HIV.  Similarly, getting blood or genital secretions into your urethra would not assure infection either.  The first step in infection however is infection of immune cells.  

No change in my assessment or advice.  EWH

[notasmartguy289]

Hi Dr. Hook, I am still worried about this. I promise this will be my last question, though I will post whether or not I got infected in a couple of weeks.

There was a lot of blood on my penis after we had sex. Again though, I finished pretty quickly and just a couple minutes after that washed off and urinated a lot. I urinated once for awhile then a few minutes later again because I drank a lot of water (I always do).

I just want to know, even if blood did get in my urethra and infected an immune cell there, that wouldn't necessarily mean I have HIV right? Do those cells always come right back into the blood stream or do they sometimes die outside/get flushed out?

I really hope I didn't catch this. I've done this before a long time ago but never had the blood exposure, though you did say it makes no difference. Still this was so stupid. This is a wakeup call and I just hope it isn't too late.

[Edward W Hook, MD]

Glad to help.  EWH

[notasmartguy289]

Dr. Hook, what I did was very stupid, I know. I am never going to do this again. I hope to have a family someday, if I caught this my life is over.

Your comments did help put me at ease. Thank you.

[Edward W Hook, MD]

Welcome to the Forum.  Your perspective interests me.  Most of our clients are worried about risk for infection from unprotected encounters with CSWs and here you are working to make sure your exposure is unprotected.  I wonder just how wise that is.

Regarding your specific question, there are many misperceptions about the topic of exposure to (usually menstrual) blood during sex.  The fact is that, among persons with HIV, there is often less HIV in blood than there is in genital secretions.  Thus your exposure to your partner's blood did not markedly change your risk for infection.  In the future, should things like this occur again, I would counsel you not to use peroxide or other cleansing agents disproportionately on your penis. This things dry out the skin and, if anything, may you more not less vulnerable to infections of all sorts.

Finally your risk all STIs from any single encounter with any new partner is rather low but, in general, the risk for typical STIs such as gonorrhea or chlamydia were higher from this encounter than your risk for HIV (less than 1 in 1000-2000 per act of intercourse, on risk).  I suggest that you get tested for these infections in the next few days (test results are reliable at any time more than 2-3 days after exposure) as well as other STIs such as HIV at appropriate times (HIV antibody tests are completely reliable 8 weeks after exposure).

I hope these comments are helpful. EWH