Help Ease My Worries

[WorriedOkie]

Over the last 18 months or so I have had exactly 5 experiences with escorts.  No encounters within the last 4-6 months.  All encounters involved the use of a condom.  No breakage or anything like that.  The condom may have slid a little bit during intercourse.  There was mutual masturbation twice (with the same escort).  I have never worried about HIV since we used protection and the condom never broke and I have read the there is basically 0 risk of transmission through mutual masturbation.  With that said, lately I have been feeling anxiety over the encounters and have debated getting tested.  I am wonedering if testing is indicated or am I just another victim of anxiety and an overactive mind?  Thanks in advance for your time.

[Edward W Hook, MD]

There will be no further answers.  The answer to theis question is obvious.  No reason not to have sex with your GF based on what has been described here.  EWH

[WorriedOkie]

Sorry to drag up an old thread.  Just had one final question for you if you don't mind.  The vast majority of my anxiety over my "exposure" has subsided.  However, just to help reassure my mind, in your opinion would it be safe to resume having unprotected sex with my girlfriend?  Thanks for your time.

[Edward W Hook, MD]

My opinion remains the same.  Take care.  EWH

[WorriedOkie]

Thanks again for your time.  I think my main concern with my episode was the fact that I believe the condom may have slipped a little, but still covered the majority of my penis.  Does your previous opinion about my relatively tiny risk still remain the same?  Thanks Dr. Hook, this will complete my questions.

[Edward W Hook, MD]

I'm not sure the answer to your questions is known.  Pesonally I suspect that there is some infection that occurs through the urethra and some that comes in through the sorts of microabrasions you mention.  I also suspect that, because of the anatomy of the penis and the fact that the skin at the head of the penis is thinner than along the shaft, that more such friction occurs at the head of the penis than along the shaft, accounting for more micro abrasion and more transmission.  It would also help explain why condom slippage is not a major reason for HIV transmission.   Please realize that this is opinion rather than fact but it makes sense to me. EWH

[WorriedOkie]

Thanks for your response to my question.  I just have one other question.  It's actually more of a curiosity.  Does HIV have to get in the urethra to cause an infection, or can it get in through micro abrasions on the penis caused by friction, such as if a condom does not cover the entire length of the penis, or if it slips a little during intercourse but still covers the majority of the penis?  Thank you for your time Dr. Hook.

[Edward W Hook, MD]

Your anxiety is misplaced.  Although your partners were relatively high risk, your encounters were protected.  In all likelihood your partners were not infected.  If they were, your risk of HIV from condom-protected vaginal sex with an infected partner is less than 1 in a million.  There is no risk at all from mutual masturbation.

Rest assured.  You have no risk from the exposures you describe and there is no medical indication for you to be tested.  EWH