escorts and HIV chances

[worrybug197]

I was going through a rough period recently and for some reason I hired 4 different escorts on 4 different occasions.  Had oral and vaginal sex once each time, so thats 4 in total.  I used a condom each time and tried my best to take off the condom properly.  Anyways, i have no symptoms at all of anything but am wondering if i should bother getting tested..what are the chances i caught something.  I also fingered a couple of them (which makes me especially nervous). I appreciate any advice you could provide.  Since they were a higher risk group i am very nervous.  Also, would taking off the condom a certain way make a difference.

thanks.

[H. Hunter Handsfield, M.D.]

I'll try to help.  The bottom line is that you can relax.  You don't say where you are, but assuming you are in the US or another industrialized country, there is no measurable risk of HIV.  Why?  First, assuming "escort" means a fairly high-priced sex worker, not a street pick-up or brothel worker, the chance any of your partners had HIV is very low, probably no higher than 1 chance in 1,000.  Second, even if any of the four women had HIV, the average chance of transmission from unprotected (no condom) vaginal sex is around 1 for every 2,000 exposures.  Third, properly used condoms are close to 100% protective.  Finally, fingering has never been known to result in HIV transmission.

So you have no worries here and no need for HIV testing.  That said, people who are sexually active outside committed relationships are wise to have routine HIV testing from time to time, like every year or two.  So if you haven't previously been tested, perhaps this is a good time, since it is on your mind.  But not because of these particular exposures.  If they are your only risks, there is no chance you were infected.

Regards--  HHH, MD

[worrybug197]

Thank you for the reply...I reside in Canada, and it was technically a brothel but it was very expensive .  I assume this doesnt change your answer though?

I guess 1 in 1000 or so seems like a high chance to me.

[H. Hunter Handsfield, M.D.]

That estimate would apply to Canada.  Escorts' prices probably correlate with lower risk more than the venue where men recruit them.

I can buy the argument that 1 in 1000 "sounds high".  But you have to combine that with the 1 in 2000 chance of transmission:  0.001 x 0.0005 = 0.0000005, or once chance in 2 million.  Since there were 4 separate events, your risk becomes 1 in 500,0000.  Put that in perspective.  According to the National Safety Council, US residents (and here too I assume Canada's statistics are similar) have 1 chance in 1,756 of dying in an accident in the next year.  And that, my friend, is 285 times higher than the likelihood you caught HIV.  And remember that is without condoms.

So from a risk assessment perspective, you really have no worries.  Do stick with condoms, however.  (And don't forget your seatbelt!)

[worrybug197]

hi again doc, just one more question if you dont mint... when you said u cant get HIV from fingering, does that stand true if you have a cut on your finger? i`m not sure if i did  at the time, but i partake in martial arts and am usually scuffed up... thanks agian.

[H. Hunter Handsfield, M.D.]

Might it theoretically increase the risk?  Makes sense.  However, fingering is perhaps the most common of all sexual practice (aside from kissing) and, cuts and nicks on the fingers are extremely common as well.  Yet no HIV transmissions are known to occur; not once has anybody reported having a patient whose only exposure to a high risk partner was fingering who then caught HIV.  Not once in 30 years of the AIDS epidemic worldwide.  Therefore, it is obvious that cuts make no measurable difference.

You're trying awfully hard to prove to me (and to yourself) that you were at risk.  You were not.  Please accept the reassurance you have been given and move on.

[worrybug197]

Hello,

I was contemplating the percentage chance i contracted the HIV virus and was wondering that if the chance of someone having the virus is combined with the chance of transmission is so low, why does the general media/public make it seem like aids is everywhere.  I guess the source of my stress is that feeling that AIDS is everywhere and easily contracted..I would appreciate any insight.

[H. Hunter Handsfield, M.D.]

You raise an important issue.  But it's less a problem of the media than it is about how people use and interpret the many information sources available.  It is true that the media often exaggerate the risks of HIV transmission.  However, the media get a bad rap.  All things considred, they probably are more often right than wrong.  Most news stories in recent years have made it clear that most HIV transmission continues to occur in especially high risk groups, like gay men and injection drug users; and that the high rates of heterosexual transmission in some places (e.g., sub-Saharan Africa) don't really apply to most people in most industrialized countries.  AIDS definitely is not "everywhere and easily contracted".

In other words, it isn't just a problem of the media, but more of human psychology:  people tend to filter the news, so they take home what they expect and what they most fear.  How do you protect against that tendency?  First, pay close attention to the source.  The NY Times is not the same as the NY Daily News or a supermarket tablid; and Fox News is not the same as NPR.  And definitely stay away from non-news sources, especially web sites that have a political viewpoint.  And be skeptical about any and all information that comes from political or religious sources.  Second, no matter what the source, read each story carefully; look for the specific populations, places, and transmission modes described -- and ask whether or not they really apply to you.

[H. Hunter Handsfield, M.D.]

You may not ask follow-up questions in a new thread, which I deleted.  Only a limited number of new questions can be accepted, and superfluous block other forum users with new questions.

Symptoms make no difference; most "flu like" symptoms are not due to HIV anyway.  This has been discussed hundreds of times on this forum; read some other threads if you remain concerned.

You have been reassured that there was no HIV risk.  Please move on.  This forum has nothing more to offer you.  There will be no further replies or comments on this thread.