Risk + Question

[InterestedHealth]

Hello. Really like the information you provide. I am a straight male who had sex with a mid to upper scale agency european female escort  in London. I used a condom but when having anal sex, without knowing, the condom slipped half off inside the lady. I estimate possibly 5cm ( 2 inches ) of the base area of my penis was exposed due to this. I did not notice any cuts or tears on my penis afterwards. I will have an hiv test in 3 months.  My questions are

1)  the statistical risk of hiv infection would you estimate from this  single exposure ?

2) is the skin at the base of the penis thicker and more resistant than the tip area of the penis to hiv infection ?

Many thanks

[Edward W Hook, MD]

Welcome to our Forum. I'll be pleased to help address your questions.  this was a no risk exposure, even in the unlikely circumstance that your partner had HIV (most commercial sex workers do not have HIV).  The protective effect of the condom is preserved as long as it covers the head of the penis, preventing access of ano-genital secretions to the mucosa of your urethra (the inside surface of the penis).  There is no reason for concern. Further, you seem to have been misinformed about when to test. Any HIV test obtained more than 8 weeks following an exposure provides definitive information. the 3 month recommendation is out of date.

As for your specific questions:
1.  Without protection, if your partner was infected, the risk for infection would be about 1 in 200 exposures. As I said above however, you were not at risk.  

2.  The issue is not the thickness of the skin on the penis but, as I said, the thickness of mucosal skin which is more susceptible to infection than the skin of the outside of the penis.

Hope this helps. EWH

[Edward W Hook, MD]

Glad to help. EWH

[InterestedHealth]

Thanks for the quick detailed answer. This helps a lot.

You are providing an excellent service.

Many thanks