Exposure

Hi,
    I've read a few of the listings surrounding this topic but want to give you the facts to my recent exposure. I was out in SF on a boys night out (involving alcohol and cocaine). At the end of the evening I ended up visiting three massage parlors where I engaged in sex with three different Asian escorts. A condom was worn on each of these occasions with no breakages. However, when I returned home I noticed a worn patch of skin 1/3 of the way up from the bottom of my shaft (about the size of a match head). I assume this was not bleeding (not sure) but it was very sensitive to the touch and started to heal over the next day. My concern is that this worn patch / abrasion was exposed throughout some if not all of these encounters. Lets face it, I wasn't in a completely great place to be making sure.  I'm extremely paranoid now to the point I can't even think straight.
   With that being said do abrasions escalate the chance of HIV dramatically? Are the 1/2000 odds completely out the window?
   What should my next steps be?
   I appreciate any input you have.
   Sincerely, out of my mind.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

Does an abrasion of the penile skin elevate the risk of HIV if exposed?  Probably a little bit -- but not much.  And remember-- you have to be exposed.  Although nobody can guarantee that any particular commercial sex worker doesn't have HIV, the odds are low -- even in San Francisco and regardless of ethnicity, whether Asian or any other.  The 1 in 2000 odds probably remain about right, IF one of your partners had HIV.

Next steps?  From a strict risk assessment perspective, you really don't need HIV testing after this sort of event.  On the other hand, if you are like most people in this situation, my reassurance alone probably won't settle all your fears.  (But I hope it helps a bit!)  If that applies to you, then you probably should be tested for the additional reassurance from the negative result.  For that reason, I suggest you visit your local health department for an HIV test at about 6 weeks.  They probably will reassure you much as I have, and you definitely can expect a negative test result.  Between now and then, try to mellow out.  The odds really are overwhelmingly in your favor.

Good luck--  HHH, MD

[Peter873]

I hope I'm using the right link now for my follow up questions, sorry for the confusion.
I have two further questions.
-If there was an infection, at eight days would there be ANY , (no matter how mild) symptoms to be noticed. I have had a sore throat for two days.
- Also I have done an RNA test today at day eight. If this is negative is that the end of the discussion?
Thank you for your understanding.

[H. Hunter Handsfield, M.D.]

Most people with new HIV infections do have symptoms, but they usually are not so mild as you describe.  A sore throat, without prominent fever, is not likely to be caused by HIV.  Probably you caught a cold, nothing more.

It was a mistake to have an RNA test done after this sort of exposure.  That test is not designed to evaluate such low risk exposures and there is a chance of a false positive result.  Probably it will be negative, which will be reassuring.  But you also need to have a standard HIV antibody test a few weeks later, i.e 6-8 weeks after the exposure.  Please follow my advice above about seeing an HIV knowledgeable health care provider, such as your local health department.

[Peter873]

Doctor, I wanted to follow up with you. I received negative results for the HIV RNA tests from the blood drawn 7- 8 days after exposure. I will follow your advice and go for further testing at the 6 - 8 week mark. I am a little relieved.
It is 17 days post exposure. My glands in my neck, arm pits and groin have been swollen for the last three days. I have a scratchy throat but no fever. I generally don't feel great.
My question to you is with ARS would everything hit at once or could it occur in this manner?
I appreciate I can only wait now for the proper testing. Sincerely.