Aa
Anal, broken condom, CSW
Dear MDs,
It's a never ending nightmare... I really though that this episode of my life is over, in fact it just got worse.
I am currently on a business trip in Indonesia (Kalimantan). Last night I had a massage in my hotel room and later was offered some extras. So, I had sex with the 22 year old girl, using a condom (that much I have learned meanwhile). Then I wanted to try anal, but couldn't really enter as she was quite tight. So we used some kind of lube and tried again, for maybe a minute. But as I still couldn't get fully in, I pulled out again. And that's when I discovered that the condom was broken!
I totally panicked, rushed to the bathroom and washed my penis with warm water and some shampoo.
When I asked her about HIV, she got quite nervous too. Maybe because she thought, that I have HIV... Anyway, I tried to clarify and she said that she is negative. And that on the 20th of September (so almost 6 weeks ago) she had got tested for the last time.
I haven't slept a single minute, I've been crying all time. I am in the middle of nowhere and feel desperate, even suicidal as I don't know how to manage the next days on my business trip and then the remaining weeks until the test.
I read that Kalimantan is one of the most worrisome areas in Indonesia. And unprotected anal is very high risk, right?
So can you tell me what are my odds? And could I go for a PCR test and when, because I am not sure if I can make it until the 6-weeks-mark for a pretty reliable antibody test?
I know that I should stay away from any kind of sex behavior that only might lead to a risk, but this time I really thought it's safe. Now my life can't get any worse anymore. Just when I thought I have recovered from my 18 months anxiety and depression, it's starting all over... But as I can't access PEP here anyway, at least I don't have to torture my body for the next 4 weeks.
Thanks for your help! It's the only one I can get here.
It's a never ending nightmare... I really though that this episode of my life is over, in fact it just got worse.
I am currently on a business trip in Indonesia (Kalimantan). Last night I had a massage in my hotel room and later was offered some extras. So, I had sex with the 22 year old girl, using a condom (that much I have learned meanwhile). Then I wanted to try anal, but couldn't really enter as she was quite tight. So we used some kind of lube and tried again, for maybe a minute. But as I still couldn't get fully in, I pulled out again. And that's when I discovered that the condom was broken!
I totally panicked, rushed to the bathroom and washed my penis with warm water and some shampoo.
When I asked her about HIV, she got quite nervous too. Maybe because she thought, that I have HIV... Anyway, I tried to clarify and she said that she is negative. And that on the 20th of September (so almost 6 weeks ago) she had got tested for the last time.
I haven't slept a single minute, I've been crying all time. I am in the middle of nowhere and feel desperate, even suicidal as I don't know how to manage the next days on my business trip and then the remaining weeks until the test.
I read that Kalimantan is one of the most worrisome areas in Indonesia. And unprotected anal is very high risk, right?
So can you tell me what are my odds? And could I go for a PCR test and when, because I am not sure if I can make it until the 6-weeks-mark for a pretty reliable antibody test?
I know that I should stay away from any kind of sex behavior that only might lead to a risk, but this time I really thought it's safe. Now my life can't get any worse anymore. Just when I thought I have recovered from my 18 months anxiety and depression, it's starting all over... But as I can't access PEP here anyway, at least I don't have to torture my body for the next 4 weeks.
Thanks for your help! It's the only one I can get here.
MEDICAL PROFESSIONAL
Welcome back to the forum. But I am concerned you have gotten into a habit of continuing potentially risky exposures and then coming here for reassurance when the risk turns out to be a bit higher than you bargained for or you otherwise lose confidence.
That pattern should stop. The answers always will be variations on the same themes: without unprotected vaginal or anal sex, there is no measurable HIV risk; most sex workers don't have HIV, even in cities or countries with especially high rates; even with unprotected sex with an infected partner, the risk for any single exposure is always under 1 chance in several hundred and usually under 1 in 1,000; very brief exposure like that described here are lower risk; and the way to know for sure (or to relieve anxiety about having been exposed) is to have an HIV test.
In this case, almost certainly your partner didn't have HIV; infected people rarely lie when asked directly. And I agree her nervousness about the condom breakage was exactly for the reason you state -- she was worried you have HIV. That was a logical response; CSWs are at higher risk for HIV from their customers than the other way around.
So I would put the chance you caught HIV during this event at no more than 1 in a million. It's low enough that you really don't need testing, except for the psychological benefit of a negative result -- assuming this reassurance doesn't erase your fears. You absolutely should not seek or take PEP.
Note that MedHelp permits a maximum of 2 questions in any 6 month period on the professionally moderated forums. This is your second since August; no more on this forum for another year. More to the point, please try to understand the general advice outlined above, as well as in the thread for which I provided a link 2 months ago -- so you won't have to keep asking about individual exposure events.
Regards-- HHH, MD
That pattern should stop. The answers always will be variations on the same themes: without unprotected vaginal or anal sex, there is no measurable HIV risk; most sex workers don't have HIV, even in cities or countries with especially high rates; even with unprotected sex with an infected partner, the risk for any single exposure is always under 1 chance in several hundred and usually under 1 in 1,000; very brief exposure like that described here are lower risk; and the way to know for sure (or to relieve anxiety about having been exposed) is to have an HIV test.
In this case, almost certainly your partner didn't have HIV; infected people rarely lie when asked directly. And I agree her nervousness about the condom breakage was exactly for the reason you state -- she was worried you have HIV. That was a logical response; CSWs are at higher risk for HIV from their customers than the other way around.
So I would put the chance you caught HIV during this event at no more than 1 in a million. It's low enough that you really don't need testing, except for the psychological benefit of a negative result -- assuming this reassurance doesn't erase your fears. You absolutely should not seek or take PEP.
Note that MedHelp permits a maximum of 2 questions in any 6 month period on the professionally moderated forums. This is your second since August; no more on this forum for another year. More to the point, please try to understand the general advice outlined above, as well as in the thread for which I provided a link 2 months ago -- so you won't have to keep asking about individual exposure events.
Regards-- HHH, MD
Dear Dr HHH,
Thank you so much for your prompt reply!
I know that there is an underlying condition in my mind and I will seek psychological support for this. I work as an expat in Asia which is very exciting, but also very tough as it's a lonely life far from home, family and friends. You easily get out of balance and try to compensate through actions that later turn out to be very stupid and even more self-destructing.
I might quit my job and return to my home country before it's too late and I cannot stop this depression anymore. Though I really love my job, but this exposure finally opened my eyes. I hope it's soon enough and I don't get punished for my continuous risky behavior now.
I really thought that the strict use of condoms would protect me when having sex with prostitutes, but ironically it didn't this time. Don't get me wrong, of course I will keep on using condoms, but I will try to change the partners I have sex with to a single and steady one which hopefully also will contribute in helping me to solve my mental problems.
Okay, I don't wanna bore you. It just helps, having this expressed once. It doesn't change the bad things I did, but maybe it makes them a bit more understandable. I am not a bad person, just a stupid one...
Thanks again!
Thank you so much for your prompt reply!
I know that there is an underlying condition in my mind and I will seek psychological support for this. I work as an expat in Asia which is very exciting, but also very tough as it's a lonely life far from home, family and friends. You easily get out of balance and try to compensate through actions that later turn out to be very stupid and even more self-destructing.
I might quit my job and return to my home country before it's too late and I cannot stop this depression anymore. Though I really love my job, but this exposure finally opened my eyes. I hope it's soon enough and I don't get punished for my continuous risky behavior now.
I really thought that the strict use of condoms would protect me when having sex with prostitutes, but ironically it didn't this time. Don't get me wrong, of course I will keep on using condoms, but I will try to change the partners I have sex with to a single and steady one which hopefully also will contribute in helping me to solve my mental problems.
Okay, I don't wanna bore you. It just helps, having this expressed once. It doesn't change the bad things I did, but maybe it makes them a bit more understandable. I am not a bad person, just a stupid one...
Thanks again!
MEDICAL PROFESSIONAL
"I am not a bad person...." Of course not. And not obviously "a stupid one" either. But being as smart as I think you are, you probably realize that anyone who acknowledges his or her own depression and ruminates on the need for "psychological support" probably really needs it. I hope you follow through.
Dear Dr. HHH
The day before yesterday I convinced the girl to get tested. So we went to the hospital and both got negative results.
So I guess unless she didn't get infected very recently (between the last 6 to 12 weeks, right?), this should be a very good sign.
Unfortunately the relief didn't last too long as I came up with a high fever yesterday, 39 degree. Today, I still feel sick, but no fever anymore. And didn't have any sore throat or rash at any time. But as yesterday was 4,5 days after the incident, it's anyway too early for ARS, right?
Thanks so much!
The day before yesterday I convinced the girl to get tested. So we went to the hospital and both got negative results.
So I guess unless she didn't get infected very recently (between the last 6 to 12 weeks, right?), this should be a very good sign.
Unfortunately the relief didn't last too long as I came up with a high fever yesterday, 39 degree. Today, I still feel sick, but no fever anymore. And didn't have any sore throat or rash at any time. But as yesterday was 4,5 days after the incident, it's anyway too early for ARS, right?
Thanks so much!
MEDICAL PROFESSIONAL
Obviously you could not have caught HIV if your partner isn't infected. That means something other than HIV is the cause of your symptoms.
I have no more comments or advice. See a health care provider about your symptoms. This thread is over; no more comments, please.
I have no more comments or advice. See a health care provider about your symptoms. This thread is over; no more comments, please.
Thanks, I just went again to the hospital and they found out that my thrombocytes are just 152.000 (instead of 200.000+). They now think that I have dengue fever...
This is really a very bad week.
This is really a very bad week.
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