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Probability of One Time Encounter
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Probability of One Time Encounter

Male 36. 8 days ago I had 20 minutes of protected sex with a 21-25yr female Cuban/Spanish prostitute in Souda Bay, Crete (Greece). She performed oral sex that led to vaginal sex. She switched to oral - vaginal a few times. Condom check? Not sure if purposeful, but I came from handing. I did not see the condom, but it was from the money collector who got it from an industrial size box of condoms. I assume a latex condom (possible spermicide). After sex she unrolled the condom and purposely held the condom up to check. I did not inspect. I never saw blood from her or myself after washing in my hotel with a wet white towel. The next day, I noticed that 3-6 hair follicles on the very very bottom base of my penis and top of scrotum (in fold) were red and inflamed on the left side only. Where a condom opening sits. I immediately saw a Military Nurse Practitioner familiar with STDs who examined under a bright light with a magnifying glass. Prognosis was chafing. It was irritated and itched for a few days. Light topical reddish chafing marks, light to touch were present for a couple days. Subsided in 3 days with some Bacitracin and baby power. No blood, puss, blisters or scaring. I took a 1000mg of Valtrex for 3 days because afraid.  What is the probability % of contracting HIV through damaged hair follicles or chafed skin at the very base of the penis and top of scrotum (seen some of your number figures based on probability factors) and would I experience and symptoms/lesions?
Tags: Oral, vaginal
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I stopped reading after the first couple of sentences.  Condom-protected vaginal sex and receiving oral sex are zero risk for HIV transmission (or close enough to zero to disregard) even if your partner had HIV, which she probably didn't.  Therefore, no matter what symptoms you have, they cannot be due to HIV from that exposure.

Now I have read the rest of your question.  As I have said innumerable times, NO SYMPTOMS RELIABLY INDICATE NEW HIV INFECTION!  That's because every single symptom of acute HIV infection occurs in many other medical conditions that are much more comon than HIV.  And in any case, you don't describe any symtpoms that suggest HIV or any other STD.  And the risk for other STDs also is very low in view of the nature of the exposure.

Bottom line:  I see no cause for concern.  Of course see a health care provider if you remain uncertain or decide you still want to be tested.  All sexually active people outside committed relationships should have periodic testing for HIV and other STDs, such as once a year.  If you haven't been tested recently, this might be a good time, since it's on your mind.  But this advice has nothing to do with your sexual adventures in Crete or with your symptoms.

HHH, MD
3 Comments
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Thank you.  I was more concerned about the damaged hair follicle and broken skin coming in contact with HIV+ vaginal fluid vise protected sex.  I understand, it is probably less than .005% or something.  Not sure of amount of blood or vaginal secretion that would have to be inducted into the area?

PS. Mandatory HIV testing yearly in my proefession.  Neg tests for 18 yrs.
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239123_tn?1267651214
No data on that specific point.  But as a guess, I would bet that 10% of all people having sex do so with inflamed hair follicles or other lesiosn that could come in contact with their partners' secretions.  Therefore, the low risk per episode of vaginal sex takes that sort of factor into account and I cannot imagine it measurably increases the transmission risk.  It takes lots of HIV to transmit infection; even sharp instrument injuries with overt exposure to contaminated blood carries a transmission risk of only 1 in several hundred.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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