protected sex with a csw

[paranoidguy850]

Hi doctor Hansfield,

Today's date is 2/27/12, I made a mistake of meeting up with a csw on 2/25/12 because now I feel guilty for cheating on my girlfriend. I was drunk that night and decided to call an escort. I had a hard time getting it up since I was drunk but not to the point where I didnt remember anything. The csw put the condom (lifestyle skyn made from polyisoprene) in her mouth and put the condom on. She proceeded to give me oral sex with the condom while holding the base of the condom with her hand for about 3-5 minutes. Then we had protected sex for about 3-5 minutes and I ejaculated. I didnt notice any blood on the condom, nor did i think the condom tear because when I took it off it seems normal. But then again I was drunk so I didnt check it thoroughly or unless the tear was really small to be noticeable. Then I wiped myself with a clean towel and drove home and 20 minutes later I took a shower. I talked to the escort and she said she is clean and gets tested every 3 months and that the last time she got her result was 3 weeks ago and that she meets a couple of clients every night. My concerns are:

1. Could I have contracted hiv from the encounter and do I need testing before I can have unprotected sex with my girlfriend again? Because if I start using a condom, she might suspect something.
2. How effective is polyisoprene condoms on preventing hiv?
3. Is lifestyle skyn condoms the same as lambskin condoms?
4. If the polyisoprene condom break, is it as noticeable as polyutherane condoms? Such as my penis would obviously show right?
5. By wiping my self with a clean towel and showering 20 minutes later, does that help preventing hiv and any stds?

[paranoidguy850]

Thank you for your professional response doctor. I will take your advice and not worry so much about it. I will try to keep it monogomous from now on.

[Edward W Hook, MD]

I see no need for testing.  EWH

[paranoidguy850]

So do I still need testing Dr. EWH?

[paranoidguy850]

Thank you doctor Hook, so I shouldnt even worry about testing right?

[Edward W Hook, MD]

There are VERY reports when person state they have use condoms on all exposures yet acquired HIV. This event is so uncomon however that it is more likely you will be struck by lightening.  Furthermore, because such reports are entirely based on self-report and not directly observed, some experts believe that the condoms may not have been use properly in these instances.    

I urge you not to worry.  EWH

[paranoidguy850]

Last question, has there been any report where a person contracted HIV from protected sex even when the condom is used properly?

[paranoidguy850]

Thank you Dr. EWH. Your response was helpful and now I can take it easy.

[Edward W Hook, MD]

Welcome to our Forum.  Dr. Handsfield and I share the forum an who answers each question is a chance event..  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

The exposure you describe was a no risk exposure.  It is statistically unlikely that your partner had HIV as most commercial sex workers do not and even if she did, condom protected sex is safe sex as long as the condom remained intact.  Your condom remained intact- when condoms fail, they break wide open leaving no doubt that it failed.   With this as a general answer, let's work through your specific questions:

1. Could I have contracted hiv from the encounter and do I need testing before I can have unprotected sex with my girlfriend again? Because if I start using a condom, she might suspect something.
See above.  I would not be at all concerned about having HIV from the encounter you describe.  

2. How effective is polyisoprene condoms on preventing hiv?
Polyisoprene condoms are at least as strong as latex and perhaps more so.  They have become increasingly popular as latex allergies have increased.  Also, please remember, the reason CSWs use condoms is to protect themselves from clients, not the other way around.  She has an interest in using a good condom.

3. Is lifestyle skyn condoms the same as lambskin condoms?
I do not follow condom brand name but since it was made of polyisoprene, it is not the same as a lambskin condom. Polyisoprene is a type of highly flexible plastic.  

4. If the polyisoprene condom break, is it as noticeable as polyutherane condoms? Such as my penis would obviously show right?
Answered above.  If the condom had broken you would know.

5. By wiping my self with a clean towel and showering 20 minutes later, does that help preventing hiv and any stds? .
Probably not, ST an HIV transmission are events that occur quite rapidly, if they are going to occur.  .

I hope my answers are helpful.  Take care. EWH