dr edward need your urgent advise

dear doctor, i have been able to sleep or function normally these few days reason being i made two terrible mistakes. 1. on monday i engaged a sex worker and she only did oral sex(unprotected) on me.
2. on wed i engaged another sex worker this time she did oral sex on me(unprotected) and we had protected sex. while we were patting she used her vaginal to lightly brush my.penis(not protected yet) for a few times and when she was putting on the condom on me i presses the tip of the condom to release the air out of the condom so it will be properly fitted as advised by durex.

on thurs i started to feel pain when i urine and some small abbrasion on my penis neck area.

i called three aids counsellor and they said i am low risk for hiv and high risk for std, they said i being over worried for asking to have PEP.

i also consulted two specialist who said the same thing and one said if i am so worried then he will advise i take the pep.

dear doctor, i hope u can advised me if i am at risk of.having hiv? i have a good life and wife, i really hated myself. i couldnt control my emotion everyday i cried. do you have patient who had similiar and turn out to be fine?

[H. Hunter Handsfield, M.D.]

Welcome to the forum. Thanks for your questions.  Dr. Hook and I take questions randomly; users don't get to select one of us or the other.  But it really doesn't matter; our styles are different, but we have worked closely together for a quarter century and our opinions and advice are always pretty much the same.

Oral sex is safe sex-- not totally risk free, but with far lower STD risks than vaginal or anal sex.  It's a low enough risk that STD experts don't recommend testing after oral sex exposures, unless symptoms develop typical for STDs.  For the vaginal sex, you used condoms -- and that's the important part.  All STDs are transmitted only by substantial exposure to the infection; the scan amount of secretions to which you would have been exposed through minor issues on how the condoms were applied, makes no siginficant difference.

And for sure there is NO risk of HIV from these events -- both because the exposures themslves were no risk and because it is statistically unlikely either of your partners has HIV.  (Even with entirely unprotected vaginal sex, if the woman has HIV, the chance of transmission is only once for every 2,000 exposures.)

I would definitely go along with the doctor who did not recommend PEP in this circumstance.  It would be a big mistake -- in my clinic, we would not do it, no matter how frightend the patient might be or how strongly he would request it.  The chance of a serious side effect or even death due to the PEP drugs is much higher than the chance you caught HIV.  If I were in your circumstance, I would not even be tested for HIV (or other STDs) and would continue unprotected sex wtih my wife with no worry about infecting her with anything.

This forum is strictly related to STDs other than HIV, and there wont' be any follow-up discussion here on HIV.  If you have any further concerns about HIV, you'll have to go to the HIV forum.  But I suggest you not spend the money on a second question.  The answer wont' be any different.

Really, stay mellow.  You aren't at significant risk.

Regards--  HHH, MD

[tronado]

thank you. how about the part whereby my penis brushed lightly against her vagina slighty when the condom was not put on yet? am i exposed to any std or hiv risk?

[H. Hunter Handsfield, M.D.]

As I said above, "All STDs are transmitted only by substantial exposure to the infection; the scant amount of secretions to which you would have been exposed through minor issues on how the condoms were applied, makes no siginficant difference." Logic tells you the same answer applies to the brief, light contact of such a touch.  Nothing to worry about.

Don't second guess my reply.  There are no other details you can think of that would change my opinion or advice.  You really shouldn't be concerned.

[tronado]

Dear Prof,

thank you for your patient and kind reply.

so in your opinion u also feel i am being over worried?

cause on thurs i had abbrasion on my penis area n urinal pain so i was worried whether it happened on thurs or much earlier when i had tat encounter with wed sex worker. do u think i in any std or hiv risk?

[H. Hunter Handsfield, M.D.]

As I said already, "There are no other details you can think of that would change my opinion or advice."  That includes the information provided here.  You definitely are very "over worried".

Nobody on this forum ever actually caught HIV following an exposure they were worried about.  That's after 8 1/2 years of questions, thousands of them.  If and when that happens, it won't be from a non-risky exposure like this one.

That will end this thread.  I won't have any furhter comments.  Try to relax and go forward with your life without worry about it.

[tronado]

dear prof,

thank you for your assurring words. i recalled on mon i had.mouth to mouth with the sex worker and i had some gum problem, my upper gum bled a little. am i in any risk of hiv or std?

i read online to be risk is when you can see.visible.blood, what does it really means? is it can see clearly n can taste it obviously?

[H. Hunter Handsfield, M.D.]

See the last comment in my last reply.  It meant what it said.  Ignore any and all additional scenarios that may come to mind. There is no information you can provide that would possibly change my opinion or advice.

[tronado]

thank you Prof for your kindness and patience. i really appreciate alot. i going through my darkness moment but you have been patience in giving me.assurring and encouraging words.