HIV - Prevention Expert Forum
HIV Risk Probabilities
About This Forum:

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.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

HIV Risk Probabilities

I went a little crazy last week and met 5 different CSWs over the course of 5 days.   I  had vaginal sex with  each of them two times. The vaginal sex was condom protected.   However,  I received uncovered oral sex about 4 times for about a minute each and performed uncovered cunnilingus on two of them for about a minute as well.

I don’t know if this relevant or not, but I believe all of them were from Korea and in each instance, they washed my genital areas thoroughly with soap and water in the shower before sex and the encounters were a few hundred dollars each. A few questions...

1. My rational side tells me this was little to no risk for HIV, but I was wondering if this equates to a risk of 1% of contracting HIV?  (1 to 1,000 risk of exposure X 10 separate encounters = 10 to 1,000, or 1% risk).

2. Should I  be worried about any other STDs?

3. I urinated about 5 minutes after each encounter. Does this reduce the risk of HIV or any other STDs in any way?

4. My friend (who is NOT a doctor) is under the belief that I am crazy for worrying about this and he believes HIV transmission from women to men is not possible.

Thank you for your assistance.


Related Discussions
239123_tn?1267651214
Welcome back to the forum.

In your previous threads -- about 2 years and 1 year ago -- you were told how low your risk of HIV was, given the sorts of exposures you described.  You seem to have had difficulty in understanding the main points of Dr. Hook's and my replies.  Let's repeat some of those messages.  In the US, few CSWs have HIV.  Heterosexual transmission of HIV is rare, even if one partner is infected; and condoms work virtually 100% of the time, if there is no breakage.  Oral sex is zero risk or close to it.  However, regardless of the risk level, the way to be sure you don't have HIV is to be tested.  It it helps you to hear the same information again, and if doing so is worth the posting fee, so be it.  But those facts haven't changed.

1) Your "rational side" is correct.  Your calculations would be correct if all your CSW partners had HIV.  But the average risk of HIV in CSWs in the US is around 0.1-1%.  If we assume the high rate (1 percent) then your risk is 100 times lower than your calculations suggest.  That makes the chance you have HIV closer to 1 in 10,000.  Just for fun, let's put that in context.  The National Safety Council calculates the average risk of accidental death among US residents at 1 in 1,756 per year (auto accidents, drownings, falls, etc, etc).  That means the chance you caught HIV is 5 times lower than the chance you'll be dead of an accident within the next 12 months.

2) The risk of other STDs also is very low, although probably not as low as for HIV.  All people who are sexually active outside mutually monogamous relationships should have routine STD/HIV testing from time to time, like once a year.  So you should be tested if it hasn't been done recently.  Most likely the results will be negative, but better safe than sorry.

3) Urinating after sex has been advocated for generations as an STD protection measure.  There are not data at all on whether or not it makes any difference.  Probably not; if it makes any difference, it's probably minor.

4) Your friend is half right.  You should not be worried about HIV; the chance you are infected from these encounters is trivial, probably zero.  But of course he is wrong about female to male HIV transmission, which definitely happens. (How does he think all those men in Africa caught the virus?  It wasn't by shaking hands!)

Congratulations on using condoms for vaginal.  Within the context of sex with commercial partners, you are doing it with maximum safety.  You should stop being concerned about individual encounters.  But at the same time, you should plan on having regular testing for both HIV and common STDs at regular intervals, like once a year or so.

Regards--  HHH, MD
7 Comments
Blank
Avatar_m_tn
For question #4, is my friend correct? or how likely is this?

Thank you.
Blank
239123_tn?1267651214
See above.
Blank
Avatar_m_tn
Thank you for your quick response.

The rational side of me tells me I shouldn't worry but asking questions on this site seems to help with my anxiety.

On the risk calcs, I realized that the 1 in 1,000 chance of HIV transmission is for UNPROTECTED vaginal sex with someone who has HIV, correct?  So, since my vaginal sex was protected, the revised risk of 1 in 10,000 is probably vastly overstated?  (1 in 1,000 X 10 exposures = 1% risk, multiplied by 1% chance CSW had HIV = 1 in 10,000)

I assume there are no risk probabilities for condom protected sex with HIV positive person?

Thank you.
Blank
239123_tn?1267651214
Yes, the risk is even lower than I calculated.  But all the estimates are imprecise anyway.  The bottom line is that it is exceedingly unlikely you have HIV.  Suck it up, get tested, and feel free to report the results here.  Other than that, this thread is closed to new comments.
Blank
Avatar_m_tn
Its been about 10 days since my last possible exposure and Ive been feeling extremely itchy in my chest and back (no rash).

I saw my doctor who did comprehensive blood work.  Everything came nack normal other than a slightly elevated liver enzyme.

1) Could this itchiness be HIV related?
2) Does HIV cause elevated liver enzymes?
3) Should I test for HIV now (12 days) or is it a waste of money?

Thank You

Should I test f

Thank you
Blank
239123_tn?1267651214
This is not a hand-holding service for people who cannot or will not accept such overwhelming scientific evidence and reasoned reassurance.  Re-read my previous replies.  You don't need HIV testing at all, and if you do it I recommend you wait until a few weeks have passed.  Do not post anything more on this forum until or unless you come back once more (and only once) to report an HIV test done 4 weeks or more after the exposure.  Anything else and the entire thread will be immediately deleted.
Blank
Continue discussion Blank
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
469720_tn?1388149949
Blank
Abdominal Aortic Aneurysm-treatable... Blank
Oct 04 by Lee Kirksey, MDBlank
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank