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HIV Risk while having Protected Sex for persons with HSV2
Hi Doctor,
I am worried sick and anxious to the point where I cannot sleep. I have HSV2, and my primary outbreak was on the scrotum just below the penis and on the penile skin at the very base, where the condom does not cover, as I got HSV2 while having condom protected sex.
Anyway, on Dec 3 I had protected sex with a sex worker at a brothel in Amsterdam. She was on top for most of the act. I am very worried that because she was on top, her vaginal secretions could have easily dripped onto the area where I have HSV2 infected skin. In fact, this could have happened inside her vagina, because since she was on top, the whole of my penis was inside her vagina, even the part not covered by the condom where I am HSV2 infected at the very base.
On Dec 24, I got sick. First I had diarrhea, and then 24 hours later on Dec 25 I had a mild sore throat, perhaps a low fever, malaise, fatigue, bloating, and nasal congestion. The low fever, malaise, and nasal congestion went away in about 3-4 days, and the sore throat and fatigue went away in 8 days. I then started to experience a lot of back pain and more bloating, but today, about 13 days later, all the symptoms are gone. I have read that all these can be symptoms of ARS. During this entire period, I was stressed immensely and could barely sleep.
Please reassure me Doctor. I am going to get tested in 2 weeks (6 weeks after the act) when it will be conclusive. In the meantime, I just want to know that HIV cannot be transmitted in the way I described, and why this is the case, why I was at no risk even though I have HSV2 and her vaginal secretions could easily touch condom uncovered parts at the base of my penis near the opening of her vagina. Please help me understand why HIV cannot be transmitted this way, so I can get some sleep.
Thank you.
I am worried sick and anxious to the point where I cannot sleep. I have HSV2, and my primary outbreak was on the scrotum just below the penis and on the penile skin at the very base, where the condom does not cover, as I got HSV2 while having condom protected sex.
Anyway, on Dec 3 I had protected sex with a sex worker at a brothel in Amsterdam. She was on top for most of the act. I am very worried that because she was on top, her vaginal secretions could have easily dripped onto the area where I have HSV2 infected skin. In fact, this could have happened inside her vagina, because since she was on top, the whole of my penis was inside her vagina, even the part not covered by the condom where I am HSV2 infected at the very base.
On Dec 24, I got sick. First I had diarrhea, and then 24 hours later on Dec 25 I had a mild sore throat, perhaps a low fever, malaise, fatigue, bloating, and nasal congestion. The low fever, malaise, and nasal congestion went away in about 3-4 days, and the sore throat and fatigue went away in 8 days. I then started to experience a lot of back pain and more bloating, but today, about 13 days later, all the symptoms are gone. I have read that all these can be symptoms of ARS. During this entire period, I was stressed immensely and could barely sleep.
Please reassure me Doctor. I am going to get tested in 2 weeks (6 weeks after the act) when it will be conclusive. In the meantime, I just want to know that HIV cannot be transmitted in the way I described, and why this is the case, why I was at no risk even though I have HSV2 and her vaginal secretions could easily touch condom uncovered parts at the base of my penis near the opening of her vagina. Please help me understand why HIV cannot be transmitted this way, so I can get some sleep.
Thank you.
Thank you doctor, that really helped assuage my fears. I wish I had asked you this weeks ago when my anxiety started. Anyway, I am going to get tested for literally everything in two weeks when I am back in the USA where I also have health insurance. After that, I am going to give up this life of promiscuity and become entirely monogamous. I just can't take the anxiety, irrational or not, of HIV and other STD's. Hopefully this is the last time I will ever post or visit this forum. I wish you the best in health and life.
MEDICAL PROFESSIONAL
Noted -- with my continuing skepticism you have it.
MEDICAL PROFESSIONAL
Welcome to this forum.
As we discussed in your recent thread on the STD forum, I doubt you have genital herpes. Until and unless you have had a confirmatory lab test (e.g., a blood test stongly positive for HSV-2, or a culture or PCR test from a recurrent genital lesion showing the virus to be present), you should not assume you have genital herpes. I strongly urge you to get tested, if that hasn't been done; you can expect good news from the result, so why not do it?
As for your current risk, whether or not you have HSV-2 doesn't make much difference. Having HSV-2 roughly doubles the risk of HIV if exposed -- so if your baseline risk of HIV is, say, 1 chance in a million (which is probably about right for the exposure described), a doubled risk makes it 1 in 500,000. That's still zero for practical purposes.
Anyway, the odds are low your commercial partner had HIV avery low. My Dutch colleagues tell me that most sex workers in Amsterdam's RLD are tested regularly, are highly educated about safe sex, and use condoms regularly, and that few have HIV.
Finally, as you apparently understand, the risk of infection from a condom-protected vaginal sex exposure is very low. In theory, could you catch HIV by infected secretions coming into contact with HSV-2 infected skin? Probably yes. But with such a low risk that it isn't worth worrying about.
As for the biological reasons, that's rather complex. The bottom line is that it is highly improbable that this event would allow sufficient amounts of HIV to come into contact with sufficient numbers of the special cells that are susceptible to initial HIV infection. See the threads below for more detailed discussion.
http://www.medhelp.org/posts/show/1119533
http://www.medhelp.org/posts/show/1319634
The main thing is that the exposure you describe doesn't warrent HIV testing at all, whether or not you have HSV-2. But assuming you go ahead with testing, you definitely can expect a negative result.
Best regards-- HHH, MD
As we discussed in your recent thread on the STD forum, I doubt you have genital herpes. Until and unless you have had a confirmatory lab test (e.g., a blood test stongly positive for HSV-2, or a culture or PCR test from a recurrent genital lesion showing the virus to be present), you should not assume you have genital herpes. I strongly urge you to get tested, if that hasn't been done; you can expect good news from the result, so why not do it?
As for your current risk, whether or not you have HSV-2 doesn't make much difference. Having HSV-2 roughly doubles the risk of HIV if exposed -- so if your baseline risk of HIV is, say, 1 chance in a million (which is probably about right for the exposure described), a doubled risk makes it 1 in 500,000. That's still zero for practical purposes.
Anyway, the odds are low your commercial partner had HIV avery low. My Dutch colleagues tell me that most sex workers in Amsterdam's RLD are tested regularly, are highly educated about safe sex, and use condoms regularly, and that few have HIV.
Finally, as you apparently understand, the risk of infection from a condom-protected vaginal sex exposure is very low. In theory, could you catch HIV by infected secretions coming into contact with HSV-2 infected skin? Probably yes. But with such a low risk that it isn't worth worrying about.
As for the biological reasons, that's rather complex. The bottom line is that it is highly improbable that this event would allow sufficient amounts of HIV to come into contact with sufficient numbers of the special cells that are susceptible to initial HIV infection. See the threads below for more detailed discussion.
http://www.medhelp.org/posts/show/1119533
http://www.medhelp.org/posts/show/1319634
The main thing is that the exposure you describe doesn't warrent HIV testing at all, whether or not you have HSV-2. But assuming you go ahead with testing, you definitely can expect a negative result.
Best regards-- HHH, MD
I'd just like to add, my HSV2 infection was recent, 4.5 months old, on Dec 3 when I visited the sex worker.
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