HIV - Prevention Expert Forum
HIV Concern
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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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HIV Concern

On the 18th of May this year I had sex with a transsexual. The t-girl was an independent escort, she said she was from Brazil but had been living in Portugal the past 2 years and was now touring the UK for a short time.
I gave her unprotected oral and I received protected anal sex from her for about 5mins. From what I could see the condom was intact the whole time and did not break or slip off but can't be 100% sure as I couldn't see too well in the position I was in.
She told me it would cost extra money if I wanted her to ejaculate, I did not pay her so at no time did she ejaculate. When I got home I would get small spots of blood on the toilet paper when wiping so I presume she must have damaged my anus slightly when entering me.
6-7 week after this I got heavy tired aching legs which lasted for about 10 days, I went away on Holiday for 2 weeks and the leg aches disappeared, when I came back the leg ache started again for a further week.
10-11 weeks after the incident I got a slight sore throat and cough, at the same time I noticed small pimple sized spots on my upper back and down the left hand side of my back also. Some of these spots were skin coloured, others were a pinky-red colour.
I am concerned that I may have contracted HIV through the meeting with the t-girl and passed it on to my partner.

Could a Doctor please answer the following...

1) Did my encounter with the escort place me at any significant risk from the activities I mentioned?
2) If a condom breaks or falls off during sex would it be obvious?
3) Could a rash like I described start after 10-11 weeks?
4) I see most website state that if any acute symptoms occur they will start between 2-4 weeks after exposure but some sites say it could happen much later than that. What is the correct timescale?
5) Please summarise if I or my girlfriend are at risk at all, and if so how likely?
300980_tn?1194933000
Welcome to the Forum.  it sounds like you are having second thoughts on this exposure.  Despite that however, if indeed the condom did remain intact, there should be no risk for HIV.  The reasons I say this are as follow:

1. You do not know that your partner had HIV.  Statistically it is unlikely that she did.
2.  Condom protected sex is safe sex. if the condom stayed intact, there is no meaningful risk for HIV.  When condoms fail, they break wide open leaving no doubt that they have failed.
3.  The risk for HIV form performing oral sex is so low that it is hard to even estimate.  Many experts use the figure of a 1 in 10,000 chance, IF your partner had HIV, and that estimate may well be too high.
4.  the symptoms of the ARS typically occur between 2 and 4 or 6 weeks, thus your symptoms beyond that do not make sense.


Thus, in answer to your questions:
1.  No, this was a virtually no risk exposure.
2.  Yes, when condoms fail, they break wide open.
3.  No as a manifestation of the ARS.
4. See above- typically 2-4 weeks.
5.  No

I hope these answers help.  If you are still worried, get an HIV test. At this time a standard HOV antibody test will provide definitive proof that you did not get HIV from this exposure. EWH
6 Comments
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Avatar_m_tn
1.NO 2.YES 3.NO 4. 2 to 4 weeks post--exposure 5.both zero risk.
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Avatar_m_tn
sorry dr handsfield,I posted in the wrong forum--my sincere mistake.
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Avatar_n_tn
thank you for your reply doctor. Would you say that I can continue having unprotected sex with my girlfriend and not have any further worries regarding the hiv concern i explained.
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300980_tn?1194933000
I would not worry further and see no reason for you to abstain from unprotected sex with your girlfriend.  EWH
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Avatar_n_tn
Im now 16 weeks since this incident and have a small lump come up on the right hand side of my neck. Could hiv cause one lymph node to swell in the neck after 16 weeks? Should I be concerned?
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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