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Avatar universal

A bit worried/ hiv

Dear doctors Hello,
I returned from Cuba 5 weeks ago. In Cuba I had a sexual intercourse with a 20 year old black Cuban girl. I dont know if to call her a sex worker or not, because in Cuba 90% of the local girls would go with foreigners for some benefits, but I assume she had plenty of partners.
She insisted on condom which gives me a little relief and also carefully went through my penis (probably to see that there are no rush or cuts or something) we started a protected sex, and I was protected during the hall period (i have noticed). During doggy style at the end I felt that she was too dry so I pulled out and saw that the condom was broken. I assume it was for a period of 30 seconds aprox. We Didnt continue further because I just couldn't mentally.
A few questions:
1. I am 22 white circumcised male, also Crhons   patient on Humira (at that point was 1 month off Humira) Does that  increas my chances of hiv? usually my imune works fine amd i barely catch anything
2. If she was totally dry, does that mean that there were less potential infected fluids?
3. What keeps me a litle better is that many people insist that cuba has one of the smallest percentages of aids in the world, and the majority of the hiv + are males. Could you confirm?
4. My freind made me feel a little better by telling me: think of the worst case ever, lets say you have it even though the chances are small, today hiv is no longer fatal and you could live a good with it. What is your opinion Doctor?

Thank you for everything you do and for your time,

Best regards
6 Responses
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to our Forum.  I will be pleased to comment.  Unfortunately condoms do break about 1% of the time.  Overall, I suspect your risk if low, for many of the reasons that you have already mentioned but sadly, low risk is not the same as no risk.   I hope that you were also tested for other STIs following this exposure. they are far more common than HIV and may be present if asymptomatic.

As for your specific questions:
1. I am 22 white circumcised male, also Crhons   patient on Humira (at that point was 1 month off Humira) Does that  increas my chances of hiv? usually my imune works fine amd i barely catch anything

The Crohn's disease does not change things but the Humira makes you somewhat more vulnerable to infections in general than if you were not on it.  How much is hard to say as this has not been studied.  

2. If she was totally dry, does that mean that there were less potential infected fluids?

Actually, that she was dry may make the risk a bit higher if anything. It is assumed that the friction associated with sexual intercourse leads to microscopic abrasions and in that way makes infection slightly more likely.  Not much but slightly.


3. What keeps me a litle better is that many people insist that cuba has one of the smallest percentages of aids in the world, and the majority of the hiv + are males. Could you confirm?

Yes, HIV is uncommon in Cuba.  In addition, please remember that most exposures do not lead to infection.  Since your condom broke during vaginal intercourse, your risk for infection is about 1 infection in 1000 sex acts even if your partner was infected which, as I noted above, is unlikely.  Thus the odds are in your favor.

4. My freind made me feel a little better by telling me: think of the worst case ever, lets say you have it even though the chances are small, today hiv is no longer fatal and you could live a good with it. What is your opinion Doctor?

This is absolutely true.  If you had acquired HIV from this exposure the disease is treatable and for persons who take their treatment as prescribed, the disease is quite manageable with most people living a close to normal lifespan.

At this time, 5 weeks after your exposure, you can be tested and find out if you were infected.  At this time, the results of a 4th generation, combination HIV p24 antigen/HIV antobody test will be conclusive.  I suggest you seek such a test and put your worried behind you (I suspect the results will be negative.)

I hope these comments are helpful. EWH
Avatar universal
Hi doctor,

Thank you for your quick reply.
So I understand that the chances are in my favor, and conclusive would be only the tests results. I would like to make things clearer if posible:

1.You said that it is not known how much the risk is increased because of humira, is it posible that we are speaking about 10 or 100 times as much?  Iif I compare to my regular life I Don't get infected much more than my freinds do.

2. You said that the chances are 1-1000 if infected. are we speaking about undetectable viral load? or even a high viral load if she didnt know she was actually positive? Is it posible to make the following calculation? 0.1% of infection lets say times 5% (worst case) of the chances she actually had something?

Best regards
300980 tn?1194929400
MEDICAL PROFESSIONAL
1.  As I said, there are no studies to suggest how much more susceptible a person would be becasue of Humira mediated immunosuppression.

2.  You are over thinking things. I provided an average figure as an example.  you are now trying to play "what if" games. this is not productive.  

Why not just get tested and put this behind you.  EWH
Avatar universal
Thank you for your reply again doctor.
You are right asking more questions will not do any good, I will do the test as soon as posible. I"ll take your quote: "I suspect the results will be negative" and keep it in my mind while waiting for results
Thanks for everything you do here.

300980 tn?1194929400
MEDICAL PROFESSIONAL
Thanks. Please feel free to post your results when they are available.  Again, I anticipate the test will be negative.  EWH
Avatar universal
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