HIV - Prevention Expert Forum
Sex with TWO female prostitutes... HIV risk?
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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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Sex with TWO female prostitutes... HIV risk?

Hello.

I am a heterosexual male who just had sex with two female prostitutes (protected, condom intact after the fact, certain of that). However, they performed UNprotected oral sex on each other and then on me (within minutes), before and after I climaxed.

I am freaking out that the vaginal fluid from one could have gotten into the oral cavity of another and then transmitted to me via oral sex. If this realistic? I know the transmission via oral sex is ZERO, but how is it in this scenario?

I want to start PEP if the chances are anything BUT zero?

Thank you so much for your help.

- Gurgen
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Welcome to the forum.  Thanks for your question.

You emphasize TWO commercial sex partners in the title you chose of your question.  That's really not the important issue.  Even in the highest risk circumstances, the chance of catching HIV from a single episode of unprotected vaginal intercourse, if the woman has HIV, averages 1 in 2,000. With two exposures, it becomes one chance in 1,000.  Still very low -- and these statistics apply only if the woman is infected with HIV, and the chance either of your parnters had the virus is no higher than 1% (1 in 100).

And on top of all that, you used condoms for vaginal sex, and oral sex carries little or no risk for HIV transmission.  The notion that vaginal secretions got into the other woman's mouth is not realistic -- and even if that happened, see my comment above about the risk of unprotected vaginal sex.

From a risk assessment standpoint, you don't even need HIV testing on account of the events described, and you certainly do not need PEP.  Any physician who agreed to prescribe PEP in this situation should have his or her medical license revoked.

If I were in your circumstance, I wouldn't even be tested for HIV.  But given how scared you are, you should have an HIV test in a few weeks.  The negative result will probably reassure you more than my words can do.  But really, you need to mellow out. You really aren't at risk.

Regards--  HHH, MD
3 Comments
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OK Dr Handsfield,

Really appreciate your help in this. I know the risks (i am a health care worker myself), but my anxiety truly gets the better of me in these cases.

I just had the worry regarding the vaginal to oral to penile mucosal transmission risk. If you say that that's not realistic at all, then I totally believe you (and your words are indeed very reassuring).

- George
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Glad to have helped.  Take care and stay safe, as you have been doing.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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