HIV Risk Assessment

[WorriedNJ213]

Dear Sir.

Recently i started seeing a young lady and we had a few great dates.  we decided to have sex and used protection as i am very HIV phobic and she only has sex using protection as well.   i had a few scabs on my penis shaft from a healed herpes outbreak i have once a year even taking valtrex every day.  they were healed enough and we decided to make love and as i was inserting into her the condom broke and i IMMEDIATELY withdrew my penis because she wasnt lubricated enough.  she said i hadnt penetrated too far but i believe my scabs may have came in contact with some Vaginal Fluid. i inspected my penis and saw no bleeding around the scabs which were superficial not deep wounds. we changed condoms and had no breakage after that.  i asked her before hand of her hiv status and she assured me she gets tested in 6 month intervals and hasnt had many partners.  to quell my anxiety i purchased 2 Oraquick oral swab hiv tests and we both took our tests the following day.  the results after 20 minutes yielded Negative for HIV for both of us as i wanted to show her i am HIV NEG and she was more than willing to test with me.  i recently found out she may be an injection drug user and i asked again of her most recent test that she said was negative 6 months ago and also tested negative usine the Oraquick Test we did with eachother in my home.  from the information i have given would this be low risk considering the half of second maybe 1 second of exposure considering she tested negative 6 months ago according to her and that our Oraquick tests yielded negative results as well?  the test was for hiv1 and hiv2.   im very nervous about this and i took every precaution i could but had no idea the condom woult break and she could be a possible IV drug user but had no track marks anywhere i could see.  

[Edward W Hook, MD]

I'll be happy to comment. Your risk for infection from the exposure you describe is quite low risk for HIV.  I reviewed your interactions on our HIV community site and agree with what was said there. You really do not know that she uses drugs and appear to choose not to believe her- unless there are other reasons for you to mis-trust her, I think you should.

Further, that she has had a negative HIV test is strong evidence that she is not infected.  With a negative test, there is little chance that she has HIV- she would have had to acquire infection within the past 6-8 weeks and this is simply statistically unlikely even if she was actively using drugs and sharing them.  

As for your encounter, even if she did have HIV (which I doubt) the risk of getting infected, even if there was contact with your herpes lesions is far less than 1%.  

All in all, this was not a high risk situation.  I would urge you not to worry.   EWH

[Edward W Hook, MD]

This is getting silly.  Testing is a personal decision. Your risk is very low.  I would not worry- you obviously are.  

This thread is now over.  Further questions will be deleted without comment.  EWH

[WorriedNJ213]

so would you say i shouldnt have to worry about testing again since my risk is what you call Quite Low Risk and that the lesions dont give a way for HIV to enter the blood stream and she tested negative with me using the oraquick mouth swab test and assured me she tests every six months?  

[WorriedNJ213]

Thanks you so much doctor hook.  I always use condoms and this severely scared me beyond belief as I had never had anything like this happen to me.   I am now confident I did not contract anything from what you have said.  You are a great man for doing what you do on this site.  I can't thank you enough. God Bless!

[Edward W Hook, MD]

Healing lesions of genital herpes do not provide the direct, deep access to the blood stream and tissues that are needed for HIV to be transmitted.  Please understand that not even direct injection of HIV into the body, such as occus with needle sticks leads to infection more than 1% of the time.  EWH

[WorriedNJ213]

And may I ask one more thing doctor.  Why is it less than 1% chance of risk if she were infected?  I was under the impression hiv is passed through small tears in skin or through a scab that has come loose or completely off before being totally healed. I.e. the shiny wet skin that scabs again after a few minutes.  Theoretically let's say one of my scabs came loose before the condom broke then withdrew as quickly as I said as soon as I felt the condom break.  how much risk would that be considering there was no visible bleeding when I looked.  Im intrigued  

[WorriedNJ213]

thank you for your re assurance sir.  i will not be seeing this woman again i can assure you of that.  i just wanted to get a professionals opinion in addition to the Oraquick test i made her take to reassure me in person even though she said she had been tested 6 months prior.  as i said i have a severe phobia of HIV and hearing she is a possible IV drug user sent me off the deep end.  so i will take her negative result i saw with my own eyes from our rapid test we did with eachother and move on with my life.  i thank you again sir for your input and hope you have a safe and happy new year.