Condom slip risk

[y2do]

I had an exposure with an csw, who gave an oral, then had sex with condom, on with drawl, i see no condom & she pulls it from vagina.

What are the chances of acquiring hiv though this incidence?

[Edward W Hook, MD]

Welcome to our Forum. You do not say where your exposure took place but, in general, any single exposure to a commercial sex worker is rather low risk for getting HIV and, in your case it is lower still.  In some parts of the world, risk for HIV among CSWs is higher than others.

The reason I state that your risk is, in general, low, is because IF your partner had HIV, and most CSWs do not, the risk of getting HIV from a single vaginal sex act is only 1 infection per 1000 exposures.  Thus, if the chance that your partner had HIV was 1 in 10 (that is 10% of CSWs in that location had HIV), your mathematical chance of infection would be 1 in 10,000.  In your case, your exposure was mostly condom protected making it still less likely.  Condoms reduce the risk of HIV by more than a thousand fold over the risk from unprotected sex.  Thus, with a condom, if your partner had HIV, the risk of infection was still less than 1 in a million.

In your specific case, I suspect that your exposure was entirely condom protected and that you came out of the condom as you were removing yourself from your partner.  If a condom comes off during sex, it typically is forced into the vaginal and none of it is apparent.  On the other hand, when the condom comes off as one leaves a partner, the condom left behind stays behind and hangs out of the vaginal as was your experience.

Can I be certain that this happened?  No but it it is likely. I suggest that you get an HIV testing 6-8 weeks.  I am confident that it will be negative when you do, proving that you did not get HIV. In the meantime, try not to worry.  You have little reason for concern.  EWH

[Edward W Hook, MD]

Each answer I give to you seems to feed your anxiety to the point where now you are asking anxiety-driven, "What if" questions which really will be of little help to you.  The following answers will conclude this thread. There will be not further answers.

1.  Of no relevance to HIV or HIV risk.
2.  Anxiety is a good candiate as a cause of dry mouth.
3.  These are issues related to guilt, not to risk or possible infection.  You need to sort this out, possibly with the help of a counselor or a loved one.  
4.  This is a what if question with no meaningful scientific answer.  Too many variables to account for. Sorry.
5.  There is no reason not to get an HIV test.  It may provide you with peace of mind when it is negative.  This really however is just another way of asking if I think you are at risk and the answer is, as it was earlier, that you are at very low, if any risk.  

This thread is now over.  EWH

[Edward W Hook, MD]

Glad to hear it.  Hearing the details, it is both unlikely that your partner ha HIV and unlikely that your exposure was unprotected.  Take care.  EWH

[y2do]

Thanks for the reply, some related queries:

1) Mouths gone dry since then & continues to be in that state.
2) Is it due to anxiety or anything else?
3) What is way to get out of this anxiety & disgust feel, even though i know that the encounter was safe.
4) How much vaginal secretion or blood needs to enter penis hole(urethra) for any hiv infection
5) Do i need to have hiv test in due course?

Will appreciate your answers

[y2do]

In fact, i went back & asked her, she mentioned the condom was half hanging out & half inside because of the state of penis, after i came. She also mentioned, that the semen was inside the condom & she did not feel any semen leaking inside her.

[y2do]

Thanks EWH, the exposure was with a escort of $250/hr in brussels, the portion of the condom was hanging out of her vagina, when i removed myself & it came of as probably she contracted her vagina & my penis had become bit placid after i came in her. I could see it & she pulled it out  from her vagina in a second & flushed it. Thus, i suspect it happened on with drawl.

[y2do]

Actually, it was with a escort posted on web, the condom was hanging out of her vagina in withdrawal, i am not sure if i lost it on withdrawal or while having sex, please help....