HIV Risk

OK-
Last night, I was in Chiang Mai, Thailand. I met a ladyboy/transsexual at a bar. I did not pay her for sex. I met her in a legitimate social situation. We went back to my place and fooled around. She gave me unprotected oral, and then I had protected anal with her. I was on the giving end and I am circumcised. I was drunk (not an excuse) but later we had anal sex again. Again, I was the one giving. However, I did not use a condom that time. I did not notice any blood and I did not *** inside her. I know this is risky behavior. My question is that as this is an isolated incident, how at risk am I of contracting HIV? As I understand it, one can't really be tested before three months of the incident's occurrence. I know it only takes one time and I plan to be tested, but I really want to know statistically how likely it is that I have contracted something and what I should do in the mean time. Thanks.

[Edward W Hook, MD]

Welcome to our Forum.  You have posted on the wrong Forum. This Forum is intended for the use of clients who are known to be infected with HIV. I will contact our moderators and request that they move your question to the HIV Prevention Forum.

As for the exposure you describe, the first question is whether or not your partner had HIV.  If there is a way to have her tested, you can take a big step in evaluating your risk for infection since if she has a negative blood test for HIV, there is almost no chance whatsoever that you are at risk for HIV.  If she is infected or if you cannot determine whether she is infected or not, then there may be some risk and it is reasonable to seek testing to rule out the possibility of infection.  There is no meaningful risk for HIV from your receipt of oral sex or from condom protected sex of any kind as long as the condom remains intact and is on throughout sex.  On the other hand, active rectal sex with a partner is associated with risk for infection and, if your partner  is infected, can be anticipated to lead to infection in about 1% (1 in 100) of encounters.

If you cannot arrange for your partner to be tested at this time, you can determine if you were infected with a "DUO" or "COMBO"  (combined HIV p24 antigen/HIV antibody) test by testing at 4 weeks following your exposure.  If you cannot access a DUO test, then the results of testing with a standard test for HIV antibody at 8 weeks following the exposure.

I hope these comments are helpful. EWH