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Hiv odds- Scare from unprotected vaginal with Massage Parlour girl

HI Dr HHH, here is my situation.( ultimately I need to get tested) So yesterday I did something stupid(as I'm married) I went with some co-workers and client to a high-end massage spa in the area.(Toronto) So we got to choose the girl we wanted a massage from, all the girls were stunning...I choose a hot girl background viet. Anyways we went for the massage and she was doing the usually massage on my back and we were chatting she was really funny and sweet. Anyways when she flipped me over she started playing with my gentials then gave me oral. After this she keep telling me how much she liked me and asking if I was married(I 'm a pretty good looking guy but i'm sure this is the routine)...She started to give me a hand job and rubbing her vagina near my gentials to simulated sex then she started making out with me and rubbing her vagina on my penis which felt great. As she started to get really wet she slipped me inside her...I freaked even though it felt good and sat up with her on top of me. She said its ok I like you. And against my better judgement I finished in the next 30 seconds inside her. I apologize if this post is graphic...I'm a 34 year old fairly healthy white male and circumcised. My question is what is the real odds of me contracting something...I had a shower with this girl after and told her I was really uncomfortable and she said she gets tested once a month and has nothing. The thing is, I don't believe I am the only guy she has done this with...that would be naive and stupid. I didn't sleep last night thinking about this and the risk I could put my wife and child at....What should I do? and should I be really scared right now? I told her that this is crazy and she should always protect herself ...she begged me to come back thursday...no way. I guess medically what are my odds I contracted hiv?...sorry again not sure how to write these lol.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
"why am I still scared about hiv? Is this anxiety or maybe guilt?"

Of course it is.

This thread is definitely closed to additional comments. This isn't a psycology support service.
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Avatar universal
Doc...thanks for your advice...my tests for chlamydia and gonorrhea came back negative...why am I still scared about hiv? Is this anxiety or maybe guilt?  
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Already answered in the link I provided June 7. I see no reason to repeat myself.  This thread is over.
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Avatar universal
which hiv test can I do at the 4 week period or sooner...thanks
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Your doctor is correct.  For maximally reliable testing, a urethral swab is a slightly better specimen than urine.
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Avatar universal
One last question, I went to get tested for chlamydia and gonorrhea ...the doctor used a swab in my urethra...he mentioned this is the best method...is that true...or is it just the same as urine?
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239123 tn?1267647614
MEDICAL PROFESSIONAL
The blood tests are quite reliable before the formal intervals recommended by most prevention agencies and test manufacturers, but don't reach 100% reliability until about 6 weeks for syphilis and 4-8 weeks for HIV, depending on the specific test(s) done.  See http://www.medhelp.org/posts/show/1704700 for discussion why HIV testing is rarely necessary as late as 3 months, even though that's the usual official advice.
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Avatar universal
I am aware of a 90 day period for Hiv testing...is that the earliest? Or could I get a fairly accurate test result earlier? Also for Syphilis testing?

Thanks
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Avatar universal
Thanks for the advice and info, this site has really ooened ny eyes to many health issues. I think I will take your advice, as I went to see the massage girl today and chatted with her to advise her that she is risking her life and health...I wont go back...I believe this scare is ebough to send me back to my safe world...thanks doctor
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239123 tn?1267647614
MEDICAL PROFESSIONAL
It is true that being uncircumcised raises the risk of HIV if exposed.  But first, you have to be exposed, and it is unlikely you were.  HIV is the least likely of all STDs your massage partner is likely to have, probably on the order of one chance in 1,000.  Anyway, being uncircumcised only doubles the risk. "Double" sounds like a lot, but it's not.  Uncircumcised, the transmission risk for a single episode of unprotected vaginal sex is around 1 in 1,000.  Circumcised, 1 in 2,000.

If I were in your situation, I would probably wait for my chlamydia and gonorrhea test results in a few days and, assuming they were negative, would resume unprotected sex with my wife.  The chance of either HIV or syphilis is low enough that I wouldn't feel a need to wait several weeks for those test results.  That doesn't mean the risk is zero, however.  If you want 100% certainty, you'll have to wait.
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Avatar universal
Thanks for the advice, I dont know much about hiv but I heard female to male transmission is low and if you have a circumsized penis its even lower is that true...also should I abstain from sex till after all testing is finished? Thx
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.  I'll try to help.  (FYI, it is only by chance I am answering.  Dr. Hook and I take questions randomly without regard to requests.  Our styles differ but our opinions and advice almost never do.)

This was a high risk exposure in some ways, lower risk in others.  If your massage partner has unprotected sex with one partner, it is indeed a good bet she does it with many.  (I'm willing to bet she has a lot of repeat massage clients!)  On the other hand, she may limit this to men she knows is married and likely mostly monogamous (like you), and many women in her situation indeed are tested frequently, so that's also a low risk factor if she was truthful about it.

Even if she had an STD, the chance of infection is always fairly low for any single encounter.  The highest risk would be chlamydia or gonorrhea (roughly 50% chance for each, if she is infected).  Even if she had HIV, syphilis, or genital herpes, the chance of transmission for any single episode of unprotected vaginal sex is under 1 in 1,000 for any of them.

That said, I think you would be wise to be tested for the most common STDs in this situation (gonorrhea, chlamydia) and for the rare but serious ones (HIV, syphilis).  The first pair can be done accurately on a urine specimen any time more than 2-3 days after the exposure.  Blood tests for HIV and syphilis need to wait until 6 weeks.  Assuming you don't develop symptoms in the next 2 weeks (abnormal pus or mucus discharging from the penis, penile blisters or sores), I don't recommend testing for anything else.

Finally, your apparent lecture to her was exactly on track.  She is behaving very foolishly by not using condoms automatically and routinely in this situation.  You'd be playing with fire to return for another round of her services.  (But if you find yourself tempted, bring your own condom and use it!)

Best wishes--  HHH, MD
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