CSW Disaster

[andyfromuk]

Hello:

My name is Andrew and I am British.  About nine months ago, I was in the UAE on business (I travel frequently) and went to one of the clubs there.  I met a Russian escort girl and we went back to my room and had sex.  It seems like a large number of the CSWs in UAE come from Russia or other former Soviet countries.  Unfortunately, my condom somehow came off, and I had unprotected sex for what must have been at least a minute or two before I realized this.  I did not *** inside her or anything.  

Whilst initially brushing off the situation, it has now increasingly played like a drum in my head and I have become just sick with worry about this.  I have been with plenty of escorts before and something like this (with the condom coming off) has never happened to me.  I do not know how many Russian girls working this way in the UAE are HIV carriers, one has to assume the percentage is substantial.

--I realize I may be overreacting somewhat, but can you give me a sense of what my risk is for having acquired HIV – 1%, 5% higher/lower etc.?

--Also, assuming I get tested, can you advise me on the best test to request?  Here in the UK, there are many different options, and my head is spinning trying to figure this out.  I am keen to have a test that a) provides the quickest feedback possible, maybe even immediately, and b) Is completely accurate, without any risk of false results, especially false positives.

Thanks so much, Andrew

[Edward W Hook, MD]

In their defense, many of the more general web sites have to be generic and conservative in their information.  We have more specific information from our clients, allowing us to provide more specific advice.  EWH

[andyfromuk]

Yes, it almost makes me feel angry that I've been mislead by the Government or other public health authorities.  I guess the idea is to scare everyone so ******** that no one ever has sex!  In fact, if you read through even hundreds of posts on this board from poor blokes like myself who had "condom misadventures" or the like, everyone always comes back and says they tested negative.  These guys are really to be commended for the info they provide.

[worried826]

Yeah these 2 docs seem to have a lot of field experience under their belts dealing with this virus and they seem to be very knowledgable about the actual risks and odds rather than playing it uber conservative like most agencies do in order to scare you into being more careful. I used to think if you had unprotected sex with an HIV+ person you were sure to get it too, apparantly that isnt so from say a one time mistake.

[andyfromuk]

Thank you Doctor - you and Dr. Handley are also both to be complicated for the
high-quality service you provide here.  I just wish I'd discovered your forum earlier.  To find out that I've been losing sleep and feeling depressed over something that is less than  1/100th of 1% almost makes me feel stupid!!  Its great that you both cut through the BS and msconceptions about this subject - keep up the great work gentlemen.

Andrew

[Edward W Hook, MD]

Go on and get a rapid test. They are accurate and will get your answer for you sooner.  EWH

[andyfromuk]

Dear Dr. Hook:  Thank you for your feedback.  I already feel infinitely better  - 1 in 10,000 is substantially smaller then I imagined even in my best case scenario.  Having spent a good part of this evening read through the archives, it sounds like the vast majority of HIV transmissions effect the regular partners of known HIV carriers, as opposed to the poor blokes like myself who suffer condom misadventures.  I assume this must have something to do with the HIV virus actually being very difficult to transmit, I have been it was like like the flu, but I gather that's not the case if the chance of acquiring it from an infected person is really less then 1 in 1,000 per sexual episode with an infected person.

Anyway, I will follow your advice on avoiding PCR or antigen test.  Quick follow-up question on that - can I get one of these "Rapid" finger ***** tests and avoid PCR or antigen?  Or, do you advise avoiding any "Rapid" tests and just going for the full blood test from the arm, even though results will take a few days?  Now, hearing that my odds are so small of having caught HIV, I'm more keen then ever to avoid the stress of getting a false positive.  Andrew

  

[Edward W Hook, MD]

Sorry to hear of your condom malfunction.  I can understand how it might concern you.  There are increasing HIV rates in Russia but, even so, the odds that the woman you had sex with was HIV infected are less than 1 in 10.  In addition, the odds of you getting HIV from a single unprotected exposure is less than 1 in 1000.  In other words, mathematically, your odds of infection are less than  1/100th of 1%.  I also understand however that it would be nice to shift discussion of probabilities to fact.  Thus, I would recommend testing.  This long after your exposure, any of the standard HIV blood tests will provide you with a reliable answer.  I would not get a PCR or antigen test--of all tests these are the ones most likely to yield false positives.

Hope this helps.  EWH