Dr. Please take a look at my situation.

Nervous about an encounter with a female professional on 6/21/2008.  Doctor, please assess my risk associated with this rendeavous.  

Details:
Male client, female provider.

1. Upon arrival, female provider peformed uncovered oral for aprroximately 30 seconds.

2. Female provider applied lubricant to penis and performed handjob for approximately 2 minutes.

3. Provider applied a lubricated condom to penis, she also applied a good helping of lubricant to her vagina. Penis was thoroughly covered in lubricant prior to application of condom.  Vaginal intercourse proceeded for approx. 5 minutes.  

4. Penis started to lose erection so provider stopped, initiated covered handjob for 1 minute, removed condom, performed uncovered handjob with lubricant for 2 minutes.  

5. Provider performed uncovered oral for 2 minutes.  Provider then applied more lubricant to her vagina and placed the original condom back onto penis.  Vaginal sex resumed for 3 minutes.

6.  During last 3 minutes of vaginal sex, I grasped my covered penis and my hand got covered with lubricant and vaginal fluid due to penis going flaccid.  Vaginal sex halted and oral resumed, uncovered, for the next 5 minutes.

7. During oral, provider asked me to masterbate myself and I did for 1 minute.  During this encounter I used the hand that was covered in lubricant and vaginal fluids.

8. Provider then performed a mix of handjob and oral, where she applied more lubricant and her saliva for 5-10 minutes until I climaxed on her body.  

Would you please advise me if my anxiety about that night should be warranted?  My health for the last 11 days has been questionable but I attribute most of my "symptoms" to anxiety.  This was my first time with a professional and alcohol was involved.  I am very upset and scared.

Please let me know your opinions, Dr.

[Edward W Hook, MD]

This question has been asked in various forms enumerable times on this forum and by rights it should be deleted, allowing you to search the site for the answers that have already been written.  Instead, I will answer it briefly before ending the thread.  No follow-up questions however.

To cut the chase, you experienced unprotected oral sex, protected vaginal sex and were masturbated by a single commercial sex worker and now are wondering about your risk for HIV.  The short answer is that your risk is miniscule and is limited to the tiny risk associated with receipt of oral sex.

Please consider;
1.  To get HIV you have to be exposed to an infected partner. Most CSWs are not infected.
2.  Masturbation is safe sex.  No one has ever been infected through masturbation, "friction" or not. Remember sex is all about friction. Please realize that in the course of masturbation miniscule amounts of genital secretions are inadvertently shared between partners, nonetheless there are no HIV transmissions which have occurred in this way.
3.  Condoms work.  You used a condom and it did not break.
4.  You received oral sex.  The risk of getting HIV through oral sex is less than 1 in 10,000 exposures, IF your partner is infected.  Neither Dr. Handsfield nor I have ever seen a person who acquired HIV from oral sex despite caring for patients with HIV since the beginning of the epidemic.
5.  Your symptoms are irrelevant and almost certainly a manifestation of anxiety. The symptoms of the ARS are TOTALLY non-specific and when people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes. In contrast, over a given year, there is almost no one who has not had a viral illness, night sweats or both (sometimes on multiple occasions).  In addition, it is also important to realize that many persons who acquire HIV do not experience the ARS.  For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.

Long story short- I would not even recommend testing in this situation. If your anxiety mandates that you must, please wait until 6-8 weeks for testing so that the results will be meaningful and repeat testing is not needed.

No further questions please.  Questions already answered elsewhere in the Forum will be deleted.  EWH

[stupidmove21]

I forgot to mention that even though lubricant was involved throughout the whole encounter, I did sustain what feels to be friction irritation to my penis, mid shaft, on the top side.  I had areas of toughened skin to date which would make me concerned about having an opening on that spot during the encounter.  I inspected my penis that day and I did not notice any open lesions, etc... but it is still an area of concern for me.  

Please take this into account when you reply to my original posting.

[stupidmove21]

Thank you for sharing your professional opinion.  

[badday103]

Actually I think the doctor misunderstood what type of oral you got.  Insertive oral according to the CDC carries a 1 in 20000 chance if the person had hiv not a 1 in 10000 ( so even better).  Also,  there is still not one documented case ever.  If you look at the Hopkins-aids site or the San Fransisco std chart they both say absolute zero for this risk.  The Hopkins site actually says that the figure 1 in 20000 is not based on fact or studies but more on guessing.  Also chances are the perso didnt have hiv so if you do the math it is truly a zero risk unless you had some sort of strange vampire **