On the early morning hours of March 2, 2013 I went to a strip club in Maryland. I was invited to the V.I.P room by a Female Stripper. Like An Idiot, I went along and before I knew it, it was me and her inside. I did not drink alcohol at all from my visit to the strip club. During our time, she sat me down and said "Let's Get Down To Business" and immediately tried to pull out my penis. I pushed her hand down from my pants. Before we engaged in anything, I asked her at the forefront did she have any Herpes, HIV, etc. She nodded her head "no" first and then answered with a more definitely-toned "no". She even swore on her grave she didn't have HIV, Herpes etc. I don't know if she herself was drunk and lying to me just to make me feel better and get my money or if she was actually telling the truth. We proceeded to have both vaginal and anal sex but during our act, the condom broke, exposing the head of my penis which I then saw was chafed some due to receiving an earlier lap dance. I had not ejaculated at this time. I immediately pulled out of her and discarded the broken condom (not sure how the long had broken before I pulled out. I do know the condom was intact when I pulled out vaginally. I assume it broke when we I was inside her for anal the first 10-30 seconds.) I put another condom on and we continued for another 5-10min with me finishing inside her. This time, this new condom did not break. Scared, I went to the nearest ER for PEP treatment. Surprisingly, the HIV Doctor told me that my exposure was relatively low-risked and that I should get an HIV test at 3months. He also recommended againt PEP treatment as I would be very sick. He said PEP would only lower the risk just a little bit from an already relatively low-risked encounter EVEN with a broke condom and raw chafing on my penis.
Can you help me doctors. What are my chances of contracting HIV from this event?
I agree exactly with your emergency services HIV doctor: this was a very low risk event that did not warrant PEP. I'm glad you didn't take it and you should be too. If you had, your anxieties would go on much longer than they need to, because after PEP testing for HIV has to be delayed for definitive results; some guidelines say as long as 6 months.
In most of the US, under 1 in 100 commercial sex workers (including strippers who get sexually involved with their customers) have HIV, and usually it's even a lot lower than that, under 1 in 1,000. And people (even CSWs) usually don't lie about it when directly asked, so it's probably even less likely in your case. And even if she had HIV, the chance of transmission during the very brief unprotected part of the exposure was very, very low.
So your risk of HIV from this encounter indeed is exceedingly low, well under 1 in several million -- low enough that from a risk standpoint, you don't even need testing. However, I still recommend you be tested for reassurance; most people gain more confidence from negative test results than from expert advice alone. You also should be tested for common STDs -- chlamydia, gonorrhea, and syphilis (although the syphilis risk is nearly as low as for HIV).
So all will be well. Don't lose any more sleep over this event.
Thank You Dr. Handsfield. I will indeed go get tested at 3 months for assurance. Just sort of nervous though because this is the first time a condom has broken for me personally, much less being chafed on the penis head. Even worse, more than likely, it broke during anal sex. When I pulled out and saw that not only the condom broke and there was chafing on my penis head and on my shaft, I sort of freaked out. Then the condom had extended even more while we were having vaginal sex because I was constantly rolling it down further while the top of the condom keep on getting longer. I thought anal sex was a high risk exposure? Is it because she was a female that my exposure risk is lower?
Anal sex is higher risk than vaginal. But we're still talking about one chance in several hundred of catching HIV, if the anal partner is infected.
The only wounds known to have resulted in HIV infection were those caused in health workers by HIV contaminated sharp instruments. A small healing wound does not materially increase the risk. (What caused your wound? Are you sure you don't have genital herpes? That is the most common cause of spontaneous lesions or "cuts" of the penis, if there was no obvious injury e.g. from shaving.)
Don't over think this. No matter what additional questions may come to mind, you can be sure this was a low risk exposure. Your test results will be ngative. And by the way, you don't need to wait 3 months for definitive testing. The duo tests (for both HIV antibody and antigen) are the norm in most of western Europe, and are definitive any time more than 4 weeks after exposure.
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