Concerned about hiv

[concerned1066]

Hi doctor,
Hopefully you can put my mind at rest regarding an encounter I had 24 days ago. It was protected oral and vaginal sex in a uk massage parlour with an African sex worker of unknown hiv status.
She put a condom on me and proceeded to give me oral sex for about 1 minute and then we had sex for about 10 minutes. After we finished she took the condom off me with some tissue paper and placed it in the bin.
I'm starting to panic a bit as I didn't really get a chance to see the condom afterward so I'm worried that it might have split or broke. I don't think it did as its happened to me before with an ex gf and it just ends up with the ring around the base of the penis
The reason why I'm worrying is because about a week after my testicles started to feel very sensitive and I had mild pain on and off (especially after I masterbated). I know this isn't a sign of hiv but it is a sign of chlamydia and that makes me think that there must have been a way of her vaginal fluids entering my urethra. I haven't had pain urinating or any discharge and they are now back to normal. I went to my local sexual health clinic and they did urine tests and I had a hiv duo test yesterday (23 days since the incident) I await the results on both tests. I've also had some spots (pimples) appear on my chest and upper thighs although they just look like spots and aren't blotchy at all.
So my questions are - 1) do you think I may have put myself at risk of hiv at all?
2) is testicular pain on its own a sign of another sti, or have I been misinformed?
3) I haven't had a fever or sore throat or anything like that but is a few spots on my chest a cause for concern?
4) could I have caught an sti if the condom remained intact?
5) do you know how many cases there are in the uk every year of males catching hiv from sex workers?
6) how reliable will be 24 day duo test be? If the sti and hiv are both negative can I relax and get on with my life?
Thanks very much.

[concerned1066]

Thanks dr hook I will.
Take care

[Edward W Hook, MD]

Glad to hear it. It is time to believe your test results. there is no need to worry further realted to he exposure you mentioned and no need for further testing.  EWH

[concerned1066]

Hi doctor, thanks a lot for the advice. My negative duo at 29 days is conclusive anyway though right?
Thanks

[Edward W Hook, MD]

The rash recently acquired HIV does not look like folliculitis which is what it sounds like you have.  If your rash were due to recently acquired HIV, which is most unlikely, tests taken 5 days before it appeared would not necessarily be positive although tests taken 5 days after it appeared would be.  

It would be a bit unusual for an antibiotic rash to appear 5 days after completion of the drugs although this is a possiblity.  Folliculitis is best managed and prevented through regular washing using a washcloth or loofah sponge to help keep the pores of the skin open.  EWH

[concerned1066]

Hi doctor,
Sorry to bother you again. Just wanted to let you know that I had my results back and the urine samples were negative for chlamydia etc and the blood test (duo) was negative at 23 days and then I had another at 29 days which was also negative.
All good news but I was hoping you'd answer some last questions for me?
I went to the gp 2 weeks ago regarding a sinus problem and the rash on my thighs. He prescribed antibiotics for my sinus trouble and fucibet cream for my thighs as he said it looked like the hair folicules had a small infection. The problem is the rash from my thighs has disappeared but I now have an even worse rash on my chest and neck (little red spots, some with white heads, some without) - 34 days after the incident. So what I wanted to know was - 1) if this rash was anything to do with hiv would the duo test taken 5 days before definitely shown antigens or antibodies? 2) I'm aware that the rash could be a reaction to the antibiotics, but they showed up 5 days after I finished the course, is this possible? (I realise this is a little off subject!) 3) does the hiv rash even look like what I have described???
Thanks again.

[Edward W Hook, MD]

Glad I could help.  EWH

[concerned1066]

Thanks Doctor I really appreciate it.
I'll hopefully get all the results tomorrow so I can (fingers crossed) get the negative results I want and move on with things!
Thanks again and take care.

[Edward W Hook, MD]

Welcome to our Forum.  I’ll be glad to comment.  I anticipate that your tests from the sexual health clinic will be negative but testing is always a good idea if you are concerned.  The reason I say this is that condom protected sex is safe sex and there is no indication that your condom failed.  While condoms do fail about 1% of the time they are used, when they due it is quite obvious that they have- they break wide open leaving no doubt that they have failed.  CSWs use condoms primarily to protect themselves.  

As for your specific questions:
1) do you think I may have put myself at risk of hiv at all?
No, most CSWs do not have HIV and condom protected sex is safe sex.  I would not be worried.

2) is testicular pain on its own a sign of another sti, or have I been misinformed?
Testicular pain can be a sign of epididymitis but this is typically accompanied by pain on urination and/or penile discharge.  When these are present they do not go away by themselves.  Thus the fact that your discomfort went away on its own and nothing was noted at the sexual health clinic suggest the discomfort you experienced was due to something other than an STD (including HIV).

3) I haven't had a fever or sore throat or anything like that but is a few spots on my chest a cause for concern?
No, an isolated ash of the sort you describe would not worry me.

4) could I have caught an sti if the condom remained intact?
There are a few reports of such things happening but they are not very believable.  Properly used condoms which remain intact offer complete protection from STIs.

5) do you know how many cases there are in the uk every year of males catching hiv from sex workers?
No but I am confident the figure is quite low.  Most HIV in the UK is contracted among men having sex with other men, just as it is in the U.S.

6) how reliable will be 24 day duo test be? If the sti and hiv are both negative can I relax and get on with my life?
The "official" time for DUO tests to provide definitive results is 28 days however, given the circumstances of your exposure, when your results are negative at 24 days I would be confident that I did not get HIV.  No further testing is needed.

I hope my comments are helpful.  EWH