HIV Risk with CSW and Condom

[bostonworried]

Hi Doctor,

With so much info online, I'm confused and have decided to stop reading all of the information, which is just stressing me out and making me lose my mind.  

I'm a hetero, circumsized male who had had sex with a CSW in Montreal and am wondering about my exposure to HIV.  She used one condom during oral and took that condom off.  She then put a new one on before vaginal sex.  I'm pretty sure both condoms used were lubricated latex condoms.  No other lubricants were used.  From what I can remember, I believe the condom remained intact during both oral and vaginal sex.  I'm pretty sure (I was a little drunk) she got off of me after I ejaculated and then pulled the condom off.  

What is my risk exposure to HIV if the condom remained intact?  Does being circumsized reduce exposure at all?  
Should I get tested, or am I stressing for no reason?  If I get tested, how accurate is a test at 4 weeks vs. 6 weeks?  

Thanks so much.  
  

  

[Edward W Hook, MD]

You are over reacting.  Do not worry.

Condoms are virtually 100% effective when used correctly without breakage,  You are far more likely to get hit by lightening than to get HIV if you have sex with a partner using a condom.  EWH

[Edward W Hook, MD]

This will be your last answer.  Yes, some of these.symptoms are compatible with the ARS but the are also typical of the flu and hundreds of other viral illnesses which you are much, much more likely to have.  As we have said time and time again, concerns based on sypmtoms are a waste of time.  Nothing more to say.  This concludes this thread.  EWH

[bostonworried]

I know I should believe that my risk was pretty much zero, but the symptoms from the past few days, almost four weeks after the incident, are making me crazy.  I was 100% sure that a condom was used and intact with a CSW in Montreal, but now I feel like my head is trying to tell me something different.  Like maybe I missed something.

Almost four weeks after the incident, I've had the following symptoms for three days now:

1) bed sweats
2) Fluctuating temperature that has gone from 98.6 to 96.8 to 103.6 (103.6 was only for a few hours and the appeared to go down after a couple Advil) to back to normal.  
3) Although temperature is normal now, I still feel too warm and still have bed sweats for some reason
4) A very painful cough that is doing a number on my lungs/chest and causing me to spit up mucus with blood occasionally.  This may also be what's causing some pain in the back of my head.
5) The neck pain I mentioned before persists and now I have shoulder pain and soreness in my lower back
6) Chills every now and then
7) haven't been able to eat in three days

Are any or all of these symptoms typical of HIV?  When symptoms occur, like ARS, can they happen within four weeks.

I know this thread needs to end, but am hoping for a resonse, reassuring or otherwise so I can undertstand what's happening.  More than anything,

Thanks...again.

[batbat8]

I like when Dr hunter or Dr. Hook said you're more likely to get hit by lightning...It's surely re

[Edward W Hook, MD]

Your symptoms are not related to the expsoure you reported. They are not typical of HIV or any other STD. On the other hand, they could easily represent tension due to anxiety and/or guilt

EWH

[bostonworried]

Hi Dr. Hook,

I know you've said my risk exposure is basically zero, but I've had neck pain on both the left and right sides for two weeks now - pretty much since this incident.  Is neck pain a symptom of HIV and is this common?  I know I shouldn't be, but the neck pain is causing me to freak out and worry pretty much non stop now.  I just can't stop thinking that the neck pain is somehow related since I've had it since the incident.

Thanks.

[bostonworried]

Hi Dr. Hook,

Thanks for the reply.  I thought I was relieved when I read your post, but I think the primitive mind is making me worry.  When you say, "...you describe warrant even testing in and of themselves," what do you mean?  Also, should I be concerned about other STIs and get tested for those?  

Last questions and I promise not other follow-up...are you saying condoms are 100% effective against HIV transmission, if used properly?

Thanks!

[Edward W Hook, MD]

Welcome to our Forum and congratulations for your plan to stop cruising the internet.  Sadly, for all of its strengths, there is also a huge amount of misinformation out there as well and sometimes it is difficult to tell what is fact and what is fiction.

The exposure you describe is zero risk for HIV.  You need not be concerned and the specific exposures you describe do not warrant even testing i and of themselves.  Most commercial sex workers do not have HIV and even with infected partners, even most un-protected exposures do not lead to infection (about 1 infection per 1000 exposures to an HIV infected partner for unprotected vaginal sex and virtually no risk for oral sex).  With properly used, intact condoms the risk goes does down more than another thousand-fold.  Thus on the basis is the numbers, your risk for HIV is less and probably far less than 1 in a million.  Put another way, you are more likely to be hit by lightening than to get HIV from the exposure you describe.

BTW, when condoms break they do not leak just a little, they break wide open.  If your condom had failed, you would know it.

Hope these comments help.  EWH