HIV - Prevention Expert Forum
Scared of HIV Infection
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Scared of HIV Infection

Dr. Doctors,


   First, I want to thank you all for the great service you all provide.  While I am sure you have answered questions similar to this many times in the past, I would feel relieved over a personal answer to my question.  A little over 3 weeks ago I made the stupid mistake of getting a very expensive escort (african american female in mid 20's) in St. Louis.  I was very intoxicated and it was the worst mistake of my life.  She gave me oral and then we had vaginal sex for approximately 10-15 minutes.  I believe I actually passed out in the middle of it.  I remember her putting a condom on me and I am almost certain that we finished using the condom as the next day it was in the trash can.  For the next two days after my penis burnt and I developed shooting pains in my abdomen about a week and a half afterwords ( though I believe this may have been caused by stress and anxiety and guilt).  The symptoms have since gone away.  My question to you all is what is the likely hood that I contracted HIV?  To date, I really have not had any symptoms of ARS (hope that I never do).   Do I need to get tested for HIV and or other STD's?  Like I said, no symptoms of anything.  I do not do drugs nor have multiple partners.    Also, I am married to a wonderful lady and I would have never done this to her without being severely under the influence.  I am abstaining from sex with her till I know if it is okay.  Can I have sex with her?  If so, does it need to be protected?  Please tell me what I should do if needed.  Thank you again so much.
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Welcome to the forum and thanks for your question -- and for reading the responses to other questions similar to yours.

In general, escorts (expensive female sex workers by appointment) are believed to have low rates of HIV, especially if they routinely have their clients wear condoms, as yours apparently does.  That she is African American somewhat increases the odds she might have HIV, but not by much.  Second, even without a condom, if a woman has HIV, the estimated average transmission risk for a single episode of vaginal sex has been calcuated to be around 1 in 2,000.  Third, you used a condom.  Fourth,  your symptoms do not suggest a new HIV infection.  (And any time someone suspects his or her own symptoms have a psychological origin, usually s/he is correct.)

I'm not sure what to make of the feeling that your penis felt "burnt", but that most suggests a chemical reaction or allergy, perhaps to the latex condom.

So all things considered, it's very unlikely you acquired HIV or any other STD, and from a medical or risk assessment standpoint, I see no need to be tested or to refrain from sex with your regular partner.  However, most people with sufficient anxiety to come to this forum probably should be tested, for the additional reassuarnce from the negative test result.  In that spirit, you probably should do it.

If you decide on HIV testing, you can do it accurately with a duo test (for HIV antibody plus p24 antigen) 4 weeks after the event, i.e. about a week from now.  You could also have a urine test for gonorrhea and chlamydia.  But the risk is sufficiently low that if I were in your situation, I would continue unprotected sex with my wife, without waiting for the test results and without fear of infecting her.

I hope this helps.  Best wishes--  HHH, MD
3 Comments
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     Thank you doctor for your quick and detailed response.  I did not describe the burning part correctly.  I meant that it felt as if the inside of my penis was on fire (urethra).  Again, this could have just been my mind as I was totally freaked out about what I had done in the days that followed.  I am not sure if my mind is telling something or not but I almost think I asked for anal sex as well, but I am almost 99.9% positive that act did not occur.  Doctor, I believe I will not get tested if you feel that I do not need it.  I have a complete physical coming up in 3 weeks (blood work and everything else) and I may just hold off until then before having any STD/HIV tests done.  Do you feel that is okay to do?  Thank you again.  And I promise no more follow up questions as I know you are quite busy.  
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If the urethral burning is continuing and is as severe as you imply, or if you notice discharge, get examined professionally to make sure you don't have gonorrhea, chlmaydia, or nongonococcal urethritis (NGU), which could be a risk if the condom failed without your knowledge.  If that symptom has subsided, however, it should be safe to wait until your scheduled appointment for STD/HIV testing.  If you decide to have STD/HIV testing, be sure and tell your doctor about the exposure; most regular health work-ups don't include STD and often not HIV testing.
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H. Hunter Handsfield, M.D.Blank
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