Cut Finger Risk from sex worker

[Doughboy23]

Hi, I have recently posted in regards to a recent experience when I visited a brothel in Australia. I received protected oral, however I had a cut on my hand at the time and I am concerned that vaginal fluid may have come in contact with my cut. I also forgot to mention that the cut was weeping at the time. I know you have previously advised me that there is no risk of HIV or blood born virus (However I some how have convinced myself there is a risk). Is it known why this is the case or is it the fact that it just doesn't get transmitted this way?

Today I went to a free clinic to try and discuss my concerns, however the only advice they gave me was to get tested which at 7 days after the event is pointless?

Sorry my anxiety is troubling me so much that I am struggling to sleep, work or just function... I am sorry if I am causing you annoyance by the re-post however I am too ashamed to my actions to discuss this with any friends and cannot visit my local doctor till next Friday.

I know you advised me that it was a complete waste of time taking doxycycline for syphilis however I have been taking 2 x 100mg per day started 4 days after the exposure and will take the full 2 week course. I know you are going to tell me I am silly but would there have been anyway that I could have become contagious before taking doxy? I understand that even if I did catch syphilis I would no longer test positive, however now I am concerned about the possibility of having passed it on.

I know the test that I got done from the clinic are unreliable as they are too soon after the incident. However if i was to get tested at 2 weeks with 4th Generation test how reliable would this test be? I have read that RNA PCR tests are accurate after 10 days? However there is no access to these tests in Australia. Do you know of any reliable companies that will do this test over the internet?

I am so sorry to waste your time but I am a wreck and have no idea what to do....

[Edward W Hook, MD]

1.  Yes, a 28 day test is conclusive.  The 6 week recommendation is overly conservative.

2. 14 days of twice daily doxycycline would kill syphilis in the unlikely circumstance that you were exposed.  No syphilis testing is needed.

This concludes this thread. My you need to move on.  EWH

[Doughboy23]

Thanks Edward. I have visited my GP who has recommended I speak to a physiologist about my anxiety...

A couple of questions in regards to my GP's visit. He told me to wait till at least 6 weeks for HIV test. He confirmed the test would be 4th generation but I would need to wait till then for a accurate result. There is a lot of talk in regards to 28 days being conclusive. In this situation would you consider my 28 day result conclusive?

I have been taking 100mg twice daily for a total of 14 days, starting 4 days after the exposure. I was told this may not kill syphilis and if I'm concerned should get tested at 12 weeks. Would consider the syphilis test conclusive at any time earlier than 12 weeks?

Sorry if anything is a repeat question I just think I would benefit from you opinion.

Many thanks. And I give my word ill never be doing something like this again! What a stupid mistake!!!  

[Edward W Hook, MD]

I am sorry that this exposure continues to trouble you.  Apparently you are not cut out for casual brothel sex.  Several times during your repeat post you mention that you realize that I have already told you this was a no risk event and you acknowledge that despite my advice to the contrary you have chosen to take doxycycline because of your fear of syphilis from the exposure.  Do you really expect me to change my answer?

Exposure of a weeping cut on your finger to your partner's vaginal secretions does not pose a risk for HIV.  I have already told you of the measures required by law in Australia for assuring that brothel workers do not have HIV or other STIs.  Even if your partner did have HIV, exposure of a cut on your finger would not pose a risk. There are no known cases of HIV acquisition resulting from masturbation of an infected partner and you are not going to be the first.  Almost immediately after a cut or scrape occurs, the healing process starts, sealing off the blood stream and deep tissues from possible infection.  Your cut did not pose a risk.

At this time it occurs to  me that your fears are getting the best of you and from your description, interfering with your daily activities and normal life.  I suggest that you discuss your concerns with a counselor.  there are many such persons working with HIV prevention services in Australia and I suspect further testing or medications will not change or address your concerns.   I say this out of concern for you, nothing more.  EWH