HIV - Prevention Expert Forum
Concerned about possible exposure
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Concerned about possible exposure

Hello,

Thank you for your expert opinion.  Last Thursday (1 week ago) I made a very poor decision and visited a csw.  I saw her ad on the intternet and visited her at a motel.  I sucked on her nipples, kissed her breasts, and fingered her,  We then proceeded to have protected oral sex (1-2 minutes) and protected vaginal sex (4-5 minutes).  I immediately disposed of the condom after completion.  My concern is that for the past 3 days I have had an extremely sore throat that has gotten considerably worse this evening. I have had a slightly elevated temperature (99.3) as well. I had a bump/rash at the base of my penis that I am not sure was completly covered with the condom  during our sexual activity.  I also noticed a cut on my right shin later that evening that was not there before.  I do not know if I got the cut while meeting with the girl.  I did not drink that evening and have no recollection of doing anything at the motel where I would cut myself but nevertheless am very concerned that I could have been exposed with an open wound.  

My questions are:

(1) I bite the skin on my fingertips (nervous habit), can this be a risk when sticking my finger inside the vagina?
(2) Should I worry about the rash/irritation at the base of my penis being exposed from the condrom?
(3) Would an open woulnd have to come in direct contact with blodd of open wounfd of infected person for disease to enter body?

Do you suggest rapid hiv testing?
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Welcome to our forum.  I'll be happy to address your questions.  The exposure you describe did not put you at risk for HIV.  First, most CSWs do not have HIV.  Even if your partner did however, HIV is spread only through penetrative genital or ano-genital sex and through injection of infected material deep into tissue. It is not transmitted through condom protected sex, through oral contact including breast sucking, or in giving or receiving masturbation even though it is typical for such activates to result in persons getting each other’s genital secretions on one another.  

As for your symptoms, I suspect they are coincidental. the symptoms of HIV typical do not begin until 2 or more weeks following exposure, not in less than a week as has been the case for you.  

As for your specific questions:

(1) I bite the skin on my fingertips (nervous habit), can this be a risk when sticking my finger inside the vagina?
No, HIV is not acquired through this sort of surface wound.  

(2) Should I worry about the rash/irritation at the base of my penis being exposed from the condom?
No, this is not a sign of HIV.  It could be due to local irritation or some other benign process.  it does not sound at all like HIV.  

(3) Would an open wound have to come in direct contact with blood of open wound of infected person for disease to enter body?
Even then transmission would be quite unusual. Despite the fact that open wounds are often exposed to HIV infected material, transmission through this sort of exposure is very, very rare.

I hope my comments are helpful. Please try not to worry.  From a medical perspective, we would not even suggest HIV testing for exposures of this sort.  EWH
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Dr Hook,

I am concerned because my sore throat has not improved in the past 2 weeks,  It feels like my throat is very raw.  I have not have a temperature above 99.3 degrees but I have had a rash that seems to come and go on a daily basis.  I went to the dr who said my throat was slightly swollen but not that bad and I do not have white pus/sores on my throat.  The doc did a strep test which was neg and prescribed amoxicillin.  The amox has done little if anything to improve my symptoms so i am assuming it is viral.  I know that you are not able to diagnos people over the computer but is it possible to have something innocent that is causing the sore throat to remain all this time?  It is very painful and seems to get worse as the day goes on.  I am debating whether to go back to the dr but am not sure what type of tests to have done?  Does this sound like something I should be concerned about?
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300980_tn?1194933000
It would be uncharacteristic for the sore throat associated with early HIV to persist for two weeks.  My advice is to not worry about HIV and to simply wait this out.  EWH
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