Should I Test

[Stressed3535]

Hello Doctor,

I had one protected encounter 14 months ago with an escort.  I have recently been diagnosed with erythmatous candidias and when asked if I had put myself at risk for HIV, I panicked and said no.  Now I am looking for a expert opinion on if I should test.  I used the internet to call a escort.  She was 22 and seemed friendly.  Once she arrived to my hotel she began with putting a condom on me that she provided and gave me protected oral for about two minutes.  I than inserted in her with the same condom on and had protected intercourse for about 5 minutes.  Here is where my questions and concerns are.  I think the condom stayed intact as I immediately got out of bed, walked to the sink and removed the condom.  I then grabbed a wash cloth and wet it and began wiping her vaginal secretions off my bottom shaft and scrotum.  I was heavily covered in her secretions as she was extremely wet.  I know for a fact that I drug her secretions across my urethra and cleaned the head of my penis with the same cloth  and could have pushed some in.  My questions are this.

1.  Should I be concerned about the condom she provided or the fact that I am not sure if it failed?

2.  Could I contract HIV by getting her vaginal secretions in my urethra less than a minute after sex?

I really appreciate your answer as this diagnosis of candidias with no use of antibiotics and from a normally very healthy person.  Thanks for your time.

[Edward W Hook, MD]

You are correct, no reason related to this exposure to abstain from unprotected sex with your regular partner.  EWH

[Stressed3535]

Thank you for such a quick response.  I will totally trust in your opinion and try to get over my fears.  I continue to replay that night in my mind and the last thing I want to do is infect my now regular partner.  I will assume that by your response you feel that its safe to continue unprotected sex with my monagamous partner.  Thanks. again.

[Edward W Hook, MD]

Welcome to the Forum.  you can rest assured that the encounter you described was virtually no risk.  Your doctor did the right thing in asking about risk for HIV and probably also asked or considered the possibility that you are diabetic or whether or not you have recently taken antibiotics.  All of these factors are associated with somewhat increased risk for fungal infection and should be routinely considered by physicians evaluating persons who present with candida infections.  Sounds to me like your doctor is doing a good job.

I should also add that most people who get candida or other fungal skin infections do not have any of the risk factors  that we look for when people present with these infections.  You may fall into that category.

As for the possibility of condom failure- when condoms fail, they break wide open leaving no doubt that they have failed.  thus from your description, you need not worry about condom failure and can have confidence that the condom did its job.

In answer to your specific questions:

1.  Should I be concerned about the condom she provided or the fact that I am not sure if it failed?
No, see above..

2.  Could I contract HIV by getting her vaginal secretions in my urethra less than a minute after sex?
No, HIV dies quickly on exposure to the environment so, even in the unlikely event that your partner had HIV (most commercial sex workers use condoms to protect themselves, not the other way around), your exposure was safe.

I would not worry if I were you.  I hope my comments are helpful. EWH