Am I ok?

Hi Dr,

I'll be as brief as I can.  I had an encounter with a local Asian CSW in my area.  We had protected sex and protexted insertive oral.  It was a brief encounter and there was no apparent breakage of the condom.  Afterward she went to remove the condom i noticed some kind of redness on the glans (glands) on my penis, which she quickly wiped away with the same tissue she used to remove the condom.  I did mot notice blood anywhere else, but do recall her being very wet (which can mean period some times).  Here are my questions

1)  Is it possible to contract hiv (or other stds) by inavertant fluid exchange after or during the condom removal?

2)  Does the transmission of the virus have to be inside her body or can it happen outside too?

3) Does this sound like high risk assuming it was either a small bit of blood that was there from condom removal or unseen condom hole?

4) Should I test?

[H. Hunter Handsfield, M.D.]

Straight to your questions:  1) No, such transmission is not known to occur.  2)  I'm not sure I understand the 'inside/outside' question.  But you used a condom, including for oral sex, for goodness' sake.  That's all that matters.  (Plus the fact that she probably did't have HIV anyway).  3) Low risk, regardless of blood.  4) I never recommend HIV testing after single exposures, especially such low risk ones.  Since you are sexually active outside committed, mutually monogamous relationships, you should have an HIV test from time to time, like once a year.  Since it's on your mind, if you haven't been tested recently, this would be a good time--but not because of this exposure.

HHH, MD

[etime1212]

6) Also could the tissue she used to wipe away redness be a biohazard to me as it has her fluid on it?

[etime1212]

When can I get a reliable PCR DNA?  Sorry to add.

[etime1212]

To clarify #3

I meant... if I my genitals/uretra comes into contact with her fluids after sex by way of hand contact, removal of the condom (draging fluid to the top) or wet bedding is that a risk for my infection (via urethra) or is the only time I am at risk during the actual coitus (assuming unprotected or with broken condom)?

Sorry if I am unclear....

[H. Hunter Handsfield, M.D.]

HIV is not transmitted by such exposure.  Only actual sex.