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HIV Prevention (Expert Forum)
Recent Possible exposure through CSW in China
Answered by
Edward W Hook, MD - HIV Prevention, stds
This forum is limited to prevention of HIV and to safe sex in general. If you believe you might have been exposed to HIV and want help to judge your risk, would like advice about HIV testing, or have questions about the effectiveness of condoms or the risks associated with specific sexual practices, this is the site for you.
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No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
Recent Possible exposure through CSW in China
by BusinessTrav, Jan 28, 2008 09:03AM
Hi Dr.
II went to an upscale massage parlour in China, where I had an encounter with a female CSW.
The sequence of events are as follows:
Protected Oral Sex - DEFINITELY
She removed this condom, and placed on another one where I had protected vaginal sex with her for around 10-30 secs. I realised what a stupid move I was making, made her stop and asked her to repeat the oral sex.
She then removed this condom, placed another one on and performed oral sex for a further 2 minutes before I decided I had had enough and left. - DEFINITELY
The psychological fear is causing me to doubt whether she placed a condom on me for the sex, even though she was so careful to protect me twice during fellatio, and in the back of my mind I know we used a condom (I had been drinking though). The fact of changing condoms for each sex act, probably means she used a condom for the sex. I can remember the entire encounter apart from this, and it is as if there is a mental block on the few seconds of sex.
I lost 3lb/3days due to stress/lack of sleep. I am going to get myself tested tomorrow, but i know there is around a 4-6 week average window time for the HIV antibodies to show if infection has occured.
My specific questions:
1. Based upon the above (sketchy) description, what are my likely chances of infection.
2. What is the current thinking on chances of HIV infection from infected female to male, on a one off, short heterosexual unprotected sex?
3. Will a HIV PCR test be accurate in 5 days?
4. Can i be tested and receive accurate results for other STD infections in 3 days (clamyd, ghonn, HSV, Syph)
5. My booster for Hep B vaccine was not received in 08/07 after receiving an (even faster) accelerated vaccine course in 08/06 of 1st day, 7th day, 14th day. Is it worth me getting an HBIG shot (3rd day) and starting another Hep B course considering the endemic of Hep B, the virulancy and the unknown efficacy of condoms?
Please help me on this matter
BT
II went to an upscale massage parlour in China, where I had an encounter with a female CSW.
The sequence of events are as follows:
Protected Oral Sex - DEFINITELY
She removed this condom, and placed on another one where I had protected vaginal sex with her for around 10-30 secs. I realised what a stupid move I was making, made her stop and asked her to repeat the oral sex.
She then removed this condom, placed another one on and performed oral sex for a further 2 minutes before I decided I had had enough and left. - DEFINITELY
The psychological fear is causing me to doubt whether she placed a condom on me for the sex, even though she was so careful to protect me twice during fellatio, and in the back of my mind I know we used a condom (I had been drinking though). The fact of changing condoms for each sex act, probably means she used a condom for the sex. I can remember the entire encounter apart from this, and it is as if there is a mental block on the few seconds of sex.
I lost 3lb/3days due to stress/lack of sleep. I am going to get myself tested tomorrow, but i know there is around a 4-6 week average window time for the HIV antibodies to show if infection has occured.
My specific questions:
1. Based upon the above (sketchy) description, what are my likely chances of infection.
2. What is the current thinking on chances of HIV infection from infected female to male, on a one off, short heterosexual unprotected sex?
3. Will a HIV PCR test be accurate in 5 days?
4. Can i be tested and receive accurate results for other STD infections in 3 days (clamyd, ghonn, HSV, Syph)
5. My booster for Hep B vaccine was not received in 08/07 after receiving an (even faster) accelerated vaccine course in 08/06 of 1st day, 7th day, 14th day. Is it worth me getting an HBIG shot (3rd day) and starting another Hep B course considering the endemic of Hep B, the virulancy and the unknown efficacy of condoms?
Please help me on this matter
BT
Doctor's Answer
by Edward W Hook, MD, Jan 28, 2008 12:02PM
, Jan 28, 2008 12:02PM
To: BusinessTrav
Your concerns are almost certainly guilt/anxiety provoked. The chances that CSW who used a condom on you (remember, she was doing this to protect herself) didn't use a condom for genital exposure is negligible. As for your specific questions:
1. Zero
2. Depends on the organism--HIV - 1 in 1000-2000 chance, gonorrhea or chlamydia, abut 20%, others, lower. They do not apply to you however as I'm sure you were not exposed.
3. No data to say yes or no. At two weeks, probably accurate
4. Yes
5. No, your prior vaccine will be protective.
Hope this helps. Nothing to be worried about. EWH
1. Zero
2. Depends on the organism--HIV - 1 in 1000-2000 chance, gonorrhea or chlamydia, abut 20%, others, lower. They do not apply to you however as I'm sure you were not exposed.
3. No data to say yes or no. At two weeks, probably accurate
4. Yes
5. No, your prior vaccine will be protective.
Hope this helps. Nothing to be worried about. EWH
Please could you inform me why the current concensus is that it is around a 1 in 2000 chance, yet so many people are being infected each year?
Thank you for your assessment - it has certainlly helped to assuage some of my fears. If you could please give me your opinion on this last factor, it would help me greatly.
Currently I am with a long term partner (g/f), and would very much like to stay in that relationship. Obviously what I done i will regret for the rest of my life. I feel i am under a moral and ethical obligation to prevent her being exposed to any risk at all, however telling her of the encounter and my fears will certainly end the relationship with no hope of reprisal, and with all the stigma attached. Simply not having sex with her for 3 months for conclusive results, without a valid excuse is not an option either.
Based on your assessment of my low level of risk, If I have the full screening of STD's and HIV Duo on 28 days, as well as a HIV PCR on 12 days, which all turn out to be negative, as well as no obvious HSV breakouts in that time, could I conservatively say that I have gotten away with this incredibly stupid encounter and can return to unprotected sex with her?
I have also taken 2g as a single dose of Azithromycin 2 days ago, which I now feel was not a great move as a -'ve chlamydia or ghonorreah test in the absence of this self-dose would have further assuaged my fears of unprotected sex.
Best regards,
BT
EWH