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Sex with a prostitute in PR

Two days ago I had protected sex with a prostitute at a strip club in San Juan. She provided oral and vaginal sex. A condom was used for both oral and vaginal sex and I believe that it stayed intact (she provided the condom and removed it so I can't be 100% sure, but I'm 99% sure). I believe the vaginal sex lasted less then two minutes, after which I ejaculated inside her.

At this time I have the following questions....
1)I am concerned if I am at risk for any STD-particularly HIV?
2) I have decided that I will get tested for all STDs. When is the earliest I can do so? I have read that HIV can't be detected for three months? Is there any way I could get a reliable result within six weeks (I live in a small Carribbean country with limited medical facilities however will be travelling to my home city in the US in six weeks).
3) I have not seen my girlfriend for two months and I am scheduled home for a visit six weeks from now. I don't want to put her at risk for anything. Is there any way I can be 100% sure that I am STD free within six weeks? If not, I don't know how I can explain to her that we can't have sex after three and a half months apart.
4) Lastly, since the encounter I have an ever so slight feeling of heat in my the bulb of my penis (no discharge or anything like that), could this mean anything?

Your response is very appreciated. This issue is weighing on my mind immensely and I have been extremely depressed, anxious and guilty ever since the encounter. Please help...
7 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
This hardly qualifies as taking it easy.  Your risk of developing genital herpes following a condom protected exposure is vanishingly low and not something to worry about.  Had you acquired HSV, you would develop genital lesions within 14 days of exposure. should this happen to you, you should get the lesion tested with a culture or PCR (note, there does not need to be an intact blister present for a culture to be taken.  They can be taken from a "bump" or open lesion.  

this will end this thread.  You need to move on.  EWH
Helpful - 0
Avatar universal
Thanks for your help Dr. Hook. I have read your comments over very carefully and I have decided to try and take it easy. One last question if you don't mind:

1) Am I in any way at risk for Genital Herpes? Is there a way I could tell if I have caught this? Also, how soon could I be tested for this if I have no symptoms (what test do you recommend)?

Thanks
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Your are asking about how to prove to yourself that you do not have HIV following a no risk exposure and it appears that you have not read my earlier comments.  You can test and test with whatever test you wish to use, that will not change the result, your exposure was no risk.  You are going to do whatever you are going to do.  Please re-read my earlier comments..EWH  
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Avatar universal
Thanks again for your response and advice Dr. Hook. I have a few more quick questions.

1) How confident are you that the antibody test would be accurate at six weeks? Could you quantify this? When you say "virtually everyone" who is infected produces Antibodies at six to eight weeks what percentage of people do you mean? I cannot wait eight weeks, it has to be definitive at six weeks or I might as well wait the entire three months (the reasons for this are complicated)

2) Secondly, I have no problem spending the money for the PCR test. Would you say this test gives an accurate result by six weeks? How accurate would it be?

I am really concerned because I am in an intimate relationship with someone, and  I don't want to take any chance what so ever with their health. Please let me know.

Thanks.

Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
PCR is a more expensive than standard antibody tests and not recommended for routine teting as there are more false postive tests with PCR (many more) than with antibody tests.  Further, the time course by which PCR becomes positve is really not well described.  

The recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some, mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or on personalized sites such as this one, feel the cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies.   EWH
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Avatar universal
Thank you Dr. Hook for your prompt and detailed response.You have put my mind at ease and I can't thank you enough. I will indeed get tested for all the STDs you mentioned in the next 4 weeks, just to put my mind at complete ease.

As far as HIV testing, I have heard that three months is needed to detect presence of HIV antibodies. Though, I know it is highly unlikely that I was exposed to HIV (and I used protection). I want to be absolutely, positively, 100% sure that I have not contracted the disease. Most things I've read suggest three month waiting, post suspected exposure if using the Antibody test. I was wondering how I could get a definitive result in six weeks? Perhaps there is a combination of reasons that I can't piece together, so if you could elaborate on this it would mean a lot.

Lastly, are there other options for definitive HIV testing that could be administered within six weeks of the exposure with results available within 24 hours? I am aware of PCR testing, how reliable is this test? I have no problem travelling and spending money to relieve every morsel of this concern from my psyche. Thank you again very much-you are providing a service that reduces people's suffering.
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to our forum. condoms are the best and most effective means of protection we have for prevention of STDs, including HIV, if exposed.  When you add the protection offered by a condom to the facts that most commercial sex workers do not have HIV and the fact that most exposures to infected partners do not lead to transmission of infection, you can be confident that you were not at risk for HIV or other STDs. Further, if the condom appeared to be intact when you finished, it was.  When condoms break, they break wide open.  they do not leak just a little.  Thus, in answer to your questions:

1.  No, not risk
2.  You really do not need testing for the exposure you describe however if you choose to be on the safe side, you can be tested for the most common STDs, gonorrhea, chlamydia and NGU at any point more than 3 days following your exposure.  Syphilis is very unlikely and not much of a concern unless your partner had a genital ulcer present at the time of contact.  Syphilis testing at 3-4 weeks following exposure is conclusive. Similarly, in this setting an HIV test at 6-8 weeks following exposure will also be conclusive.  Testing should be available at the public health STD clinics in Puerto Rico if you wish.
3.  See above.  You really need not worry.
4.  Unlikely.  Sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned.  This in turn leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times.  Perhaps this was a contributor to your situation.  Testing as outlined above will tell the story definitively.


Hope these comments are helpful. You really need not worry.  EWH
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