HIV - Prevention Expert Forum
Unprotected Vaginal Sex
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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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Unprotected Vaginal Sex

Doctors,

Last night, I went to a latino night club about a half hour from New York City and ended up having unprotected sex with a female who works at the club. It's not a strip club, but it's a place where women will dance and talk with male customers when they buy them drinks, in which case they earn a commission when men buy them drinks.

I've known this woman for almost a year, simply from going to the club and staying in contact by phone occasionally.  She's from Mexico, around 30, and has lived in the NYC area for over 5 years.  The encounter included unprotected vaginal intercourse, unprotected oral sex on me, and unprotected oral sex on her. The whole event lasted about an hour. This clearly went against my better judgment.  I guess I let it happen because I've somewhat known her for a while and foolishly took comfort in knowing that there's no lap dances or sex happening in the club.  

What has gotten me so nervous is the fact that I have to assume that she must also engage in similar unprotected sexual activities with other males that she meets at the club. When I asked her about this, she told me that she doesn't have sex with anyone she meets at the club. Now I don't know how much I could actually believe this, considering she did it with me. However, I asked her a second time, and she seemed kind of taken back about the fact that I thought she might do this sort of thing with others. This made me feel a little better, but I just don't know how much I could actually trust that she's telling me the truth, based upon the line of work she's in.

Could you please assess my situation:

1. How much risk did I put myself at for HIV?
2. How much risk did I put myself at for other STD's?
3. I read on another post that the eastern cities in the US carry more risk relating to HIV.  Is this true and should I be more concerned about this?
4. Do I need to be tested, and if so, when can I test for HIV and other STD's?

Thank you

        
300980_tn?1194933000
Welcome to the Forum. I'll be glad to comment.  On one hand, I do agree that a modest amount of skepticism seems reasonable as to whether this woman has had other partners through her business or not. Even if she has not, she has had other partners and you do not know when or whom.  In general we recommend screening for any of our clients who have had sex with new partners or partners who may have had other recent partners since they were last checked.  As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).   In your case, the main things to be tested for are chlamydial infection and gonorrhea and these tests can be performed at this time and will yield accurate results.  The risk for HIV or syphilis is far lower and these tests take longer to become positive- typically 4-6 weeks.  

1. How much risk did I put myself at for HIV?
Very low. Fewer than 1 in 10,000 women in the U.S have HIV and even if your partner did, the risk for HIV is only 1 infection per 1000 sex acts.

2. How much risk did I put myself at for other STD's?
These infections are more common than HIV but still not particularly so.

3. I read on another post that the eastern cities in the US carry more risk relating to HIV.  Is this true and should I be more concerned about this?
I would not worry particularly about this.

4. Do I need to be tested, and if so, when can I test for HIV and other STD's?
See above. In the absence of symptoms this is not a priority but it is also a reasonable thing to do at some point in the future.  

I hope my comments are helpful. EWH
7 Comments
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Dr. Hook, thank you for your response. I forgot to ask in my original post if I should consider PEP in this circumstance, as this just happened last night.

Thanks again
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300980_tn?1194933000
No, I certainly would not even begin to consider PEP.  EWH
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Avatar_m_tn
Ok, thanks very much Dr. Hook.
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Avatar_m_tn
One quick follow-up...For my own understanding, am I correct in calculating the mathematical risk of HIV in my particular situation to be (1/10) * (1/1000) = 1 in a ten thousand?



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300980_tn?1194933000
If there was a 10% probability that your partner had HIV, this calculation would be correct.  In actuality I expect that your risk if at least 10 times lower than this (i.e. 1 in 100,000) and probably lower.  EWH
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Avatar_m_tn
Dr. Hook, Thanks
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