Need HIV assesment

[kayvan_p]

Hello Doctors I am writing to you today looking for guidance and reassurance.

I’m a married adult white male I live in San Jose, Ca. Before my wife and I were together we both got tested for HIV/STD’s and were negative for everything. Last week I did something I have always just wanted to try. I hooked up w/ a transsexual prostitute (man with boobs). I saw her under erotic services on craigslist and called her late one night (she was Mexican, very beautiful & looked like a woman). She was in a nice hotel downtown San Jose and she performed oral sex on me and we made out also. Towards the end I also jacked her off for a little. And then I basically left.

I feel no guilt for cheating on my wife or the fact this was my first experience with a man. But I also do know gay men are at high risk for HIV which is why I’m here. At the end of my experience with the tranny she gave me sanitary wipes and said it’s always good to be clean she also had a bag full of condoms next to the nightstand. She then asked if I was clean, and I gave her kind of a rude answer like what do you think and I left.  A few days later I felt bad and called her and told her I have been tested & that I was clean and asked if she was also. She said she was clean also and that it always good to be clean and that she takes care of herself. And that was it (I hope she wasn’t lying I don’t see why she would)

Questions-

1) I guess you could insert advice here about hooking up w/ a tranny prostitute.
2) As far as I’m aware RECIEVING oral sex and giving a hand job and making out are all zero risk as far as HIV in concerned correct?
3) I’m not planning on getting tested for this one time encounter (I will annually if I continue this behavior which I think this was a one time thing). The only reason I will test is if I get some crazy symptoms in the next few weeks and even then I realize if I do it still doesn’t mean I have HIV. Does this sound like a good plan?

[kayvan_p]

thanks doctor it feels good to be able to move on from this

[Edward W Hook, MD]

Your risk is not zero, at least in theory but it is very close to zero.  I would not worry aobut  HIV and therefore see no reason for you to abstain from sex with your wife. EWH

[kayvan_p]

Thank you doctor. So if I understand correctly I couldn't get HIV from these sexual acts and don't need testing but if I do continue similar behavior to be smart and couscous correct?

also so it's ok if my wife and I have sex correct? Because we haven't used condoms since this should we be ok not using condoms??

[Edward W Hook, MD]

I think that your approach to this encounter is appropriate.  It is always good to ask your partners about their HIV status (although next time, far better to do it before sex).  From all that you say about your partner (her assurance to you, the condoms, etc) I suspect that indeed she was telling the truth.  In addition and perhaps even more important, the sex acts you engaged in were low risk.  There is no risk from masturbation and oral sex is very, very low risk.  The quoted figure for HIV risk, if one receives oral sex from an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  

As for your specific questions:

1.  A transsexual commercial sex worker, statistically, is a high risk partner.  Despite that, on a statistical basis she was likely not infected. Her characteristics make that even more likely than on average.  Does that make her no or even average (for the population) risk - no , by no means but relatively low risk amongst such partners.

2.  Kissing - zero risk.  Receipt of oral sex, very, very low risk.  See above.

3.  I doubt that you need testing for this single encounter.  On the other hand, should you choose to continue this behavior, it would be a good idea to get yourself tested on a regular basis.

Hope this helps.  EWH