Condom broke with commercial sex worker in south america

[Worried1111]

4 weeks ago, I (27yo m) had sex with a commerical sex worker in south america. I did not have an erection so she began to give me oral sex with a condom on the tip of my penis. After a few minutes she tried to insert the condom in her vagina. She moved back and forth for a few minutes, but my erection never really came - sort of a semi - so she began to give me oral sex again. At this point, realized condom broke. She said it broke in her mouth, but I can't be sure. 48 hours later I developed a fever of 99.4 that lasted 12 hours. 2 weeks later I developed a swollen gland on right of my neck. I went to doctor who said throat was VERY red and I had otitis externa (which later turned into otitis media). Two weeks later, throat still red with the right side (gland) still swollen. I had tonsil stones, and some white stuff on my tonsils. Dr gave me antibiotics. Not swollen on left side of neck, not swollen in armpits or groin. Doctors at clinic said the girls at that place are tested every three months by law and always use condoms, but accidents can happen. Qs: 1) If this is strep is this diff than sore throat with ars? and if not strep should I be concerned? It is not candidiasis according to docs. 2) is the right swollen gland different than lymphadenopathy with ars? 3) am I at lower risk due to not having a full erection? 4) does this sound like ars? 5)Is it true what the cdc says that condom breaks very rarely lead to infection?

[H. Hunter Handsfield, M.D.]

No STD causes symptoms within 48 hours.  You caught a garden variety respiratory virus or maybe strep throat; and the timing suggests you might have caught that from the sex worker.  But it isn't HIV.  But if you're worried about HIV, get tested to settle your fears.

1,2,4) ARS cannot start less than 7-10 days before exposure.  There are no exceptions. Most of the many infections that can cause sore throat also cause lymphadenopathy (lymph node inflammation) in the neck.  By itself that does not suggest HIV.  3) There are no data on HIV transmission risk with or without a good erection; I doubt it makes any difference one way or the other.  5) Your doc is right.  Your commercial partner probably didn't have HIV (most do not); and even if she did, with no condom at all, the chance of transmission by vaginal sex is roughly 1 in 2000.  That means you could expect to have unprotected sex with an infected CSW every day for up to 5 years before you would expect to catch HIV.

Good luck---  HHH, MD

[backstabbed05]

thread jumping is SO rude, I hope he doesn't answer you.

[H. Hunter Handsfield, M.D.]

You're absolutely right. I deleted quintonmed's thread jump.

[Worried1111]

The sore throat and swollen right gland actually started two weeks after the incident.  I was given a generic amoxicillian which an ENT said was not a good drug and put me on cifradina which seems to be working.  Does the timing (2 weeks after the incident) change your opinion?

Thank you for all your hard work.  I really appreciate your prompt reply.  If there is a location I can donate money to your clinic or foundation, kindly let me know via this thread.

All the best

[H. Hunter Handsfield, M.D.]

My 2 day comment was related to your initial fever; I didn't realize the sore throat etc started later.  Still, the chance this is HIV is extremely low compared with the likelihood of a respiratory virus or strep throat.  I'm not familiar with "cifradina" and suspect you are misspelling it--but it sounds like it's clearing things up.  Follow your docs' advice about follow-up.

Thanks for the thanks about the forum. If you want to follow through with a donation, use the contact link to discuss it with the MedHelp office.

[Worried1111]

Will follow up with them.  Thanks again.

[Worried1111]

La cefradina es un antibiótico de cefalosporina usado para tratar ciertas infecciones causadas por las bacterias como la neumonía y las infecciones de oído, piel, garganta y vías urinarias. Los antibióticos no tienen ningún efecto sobre los resfríos, gripe u otras infecciones víricas.

In other words: Cefradina is an antibiotic of cefalosporine usd to treat certain infections caused by bacteria like pneumonia and infectinos of the ear, skin, throat, and the urinary tract. The antibiotic does not have any effect against the flu or other viral infections.

Does it sound like this would not have been perscribed if it were ars or not be effective if it were ars? Do you think an antibody test is in order at 6 weeks or can I rest easy?

By the way, have contacted your administration office for the donation.  Following up on my word!

[worriedcrazy1234]

Is 99.4 even a fever? I thought 100+ qualified as a fever.