Reg: Possible risk assesment

Hi doctors,

On December 15th I had a protected vaginal sex with a sex worker,she is from Vietnam. It lasted 5- 7 mins after that the sex worker masturbate me with condom on. Then I came back home with condom still in my penis and sleep with that. I was completely drunk so forgot to remove the condom. As the penis shrink condom automatically came out from penis. I checked the condom next morning, it was not broken.
Exactly 29 days after the exposure I had high fever around 102 degree it goes away within 2-3 days like a normal viral fever.
After the fever, I developed red color bump rashes on my chest.It's look like Seborrheic dermatitis. I'm not sure though.
The rashes autometically goes away after 2 weeks & then red colour itchy rash come on my upper chest.
I applied some medicine and it goes away within 4 - 5 days.
Now after 2 month of exposure, some time I feel slight pain on my penis. which lasted hardly 5 min and autometically goes away.
Since I had protected sex, I convinced myself that I can;t caught HIV,but with this symptoms I am getting very worried.
That was my first exposure.  

I have few question.

1. What is my risk of catching HIV & STD?
2. Is Seborrheic dermatitis is common in early stage of HIV?
3. Do I need any testing?
4. After wake up in the morning I feel fatigue in my legs. Is this because of HIV or stress?

Please help me doctor to assess my risk.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  I'll try to help.

You describe a low risk exposure.  It is statistically not likely that your partner has HIV.  This depends a bit on where you are, and other circumstances of her life -- but most likely she isn't infected.  Second, you used a condom.  Having the penis slip out of the condom is quite common and it doesn't mean the sex was not protected.  It was -- and you cannot catch HIV through an intact condom.  The risk of other STDs also was very low.  Condoms work!

HIV symptoms, including fever and rash, cannot start 29 days later.  Symptoms of a new HIV infection start 10-20 days after exposure.  To your questions:

1) Zero risk for HIV and probably zero for gonorrhea and chlamydia; slight risks (but still low) for syphilis, herpes, and HPV.

2) No.  Seborrheic dermatitis is a sign of advanced immune deficiency, typically many years after the initial HIV infection.  Anyway, seb derm occurs very commonly in healthy people.

3) From a medical or risk assessment perspective, no testing is needed.  However, anyone who is worried about having HIV should get tested.  A negative result is usually a lot more reassuring than verbal advice on this forum or anywhere else.

4) HIV doesn't cause such a symptom.  And whenever a person suspects his or her own symptoms have an emotional or psychological origin, usually s/he is correct.

Enough time has passed for accurate HIV testing, so visit a doctor or clinic and have it done.  If you like, you also could have tests for common STDs.  This does not mean I believe there really is a significant chance you are infected; I do not.  But the negative results will make you feel very good, so just go do it.  Feel free to return to tell me the results.

Regards--  HHH, MD

[bose1234567]

I'm currently in Singapore. I don't know her HIV status. But I remember she insisted to use condom and even with condom she refused to do Oral because she was having some cut on her mouth.
Does it signify that the girl is conscious about her own health.
I can't test HIV in Singapore. I will do it when I will back in my home country.
I will update the test result.

[H. Hunter Handsfield, M.D.]

Yes, I think that when sex workers insist on condom use, it is a sign they are conscious and concerned about their own health.  It usually means they know they don't have HIV and intend to stay uninfected.

Try not to worry about this before you are tested.  You definitely can expect your test result to be negative.