unprotected sex with a transsexual prostitute

This happened about a week ago.  The whole encounter lasted no more than 15 minutes, most of the time we gave each other fellatio.  Then I took a huge risk and asked him/her to penetrate me anally.  They used some spit as lubrication and inserted, but I asked them to stop after what must have been less than 10 seconds (3-4 thrusts) because it was painful.  I did notice however that he generated no precum whatsoever (at least as far as I could tell) and he commented on how much I precum.  Also he was circumcised I am not.  So after this I went back to sucking while he jerked me off.  So after having effectively played Russian roulette here I plan on getting an hiv test, but I would like some input beforehand as to the risk factors.  I do not usually engage in risky behavior like this, in fact this is the first time I have had sex of any kind in over year since breaking up with my ex girlfriend of 3 years (so total of 2 different partners in 4 years).  I read somewhere that the risk of transmission for receiving anal is somewhere around 2% with ejaculation, but I also have heard that the prevalence of HIV among transsexual prostitutes is anywhere from 30%-50% and I took a virtual HIV test and it put my risk factor at a frightening 60%, I think due to the fact that I estimated he had over 150 partners per year (probably a fair estimate)?  This was also the first time that I solicited sex from a prostitute (and is most definitely the last).  I would appreciate any comments or feedback on my incredibly stupid and dangerous behavior.  Thanks.

[Edward W Hook, MD]

The risk of this exposure is heightened by having unprotected sex with an extraordinarily high risk partner.  The rectal site also is associated with very high risk.  With your symptoms of fever and flu-like symptoms it may be worthwhile to see a health care provider who can perform an HIV PCR on you to rule out that your symptoms are due to the Acute retroviral syndrome.  If this test is negative, your should have the serological test at some point between 4-6 weeks after the exposure and then again at 12 weeks.

Please do not do this again.  It puts you at great risk. EWH

[john976]

Sorry I forgot to mention although it is probably obvious this was all unprotected without a condom, and its about 10 days later and I have come down with flu-like symptoms fatigue muscle aches, bit of a fever.  I think this might just be a cold due to stress from exams however.

[jenkinjimmy]

John, what were you thinking? You NEVER have unprotected sex with anyone whose HIV status you don't know. This applies doubly to escorts, and a million times more to someone who has probably had anal sex with gay men. In my opinion you need to get tested for sure in about six weeks. You should have seen a doctor the next day to get PEPs, but thats too late now. Lets see what the doc tells you. Good luck, man.

[john976]

Thank you for your responses.  I must say on the bright side this incident has definitely scared me straight and given me a new outlook on life.  My cold symptoms have pretty much disappeared today except for fatigue I feel fine, but this probably isn't an indicator of anything at this point.  I am clinging to the hope that there was very little pre-seminal fluid exchanged and the transmission would have had to occurred in only a few seconds (except for the oral which I know is less chance), but then again as you both mentioned this was a super high risk factor being a prostitute.  I'll have to see what the test results say, the waiting is definitely the hardest part...