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HIV Risk in Thailand
Last month I took a vacation to Thailand, and I ended up receiving unprotected oral sex from four different sex workers and I had semi-unprotected vaginal sex twice with the same sex worker. I say semi-unprotected because the condom broke at some point during intercourse and I didn't notice both times, but for practical purposes I'll just say it was unprotected sex. How long I was having unprotected sex for, I'm not sure. In any case, this probably should have worried me more than it did, but I read the female to male HIV transmission risk is low so I enjoyed my vacation and didn't stress too much.
However, about a week after those incidents (they were about a day apart) I noticed pain in my testicles and penis, and I also had a discharge. I was treated for gonorrhea at the local clinic, and everything was cleared up. I was tested for both gonorrhea and chlamydia but only tested positive for gonorrhea. No more symptoms, although the rest of the week I was feeling a bit under the weather and overall generally sick. Sore throat, perhaps a light fever (I never checked my temperature), but not much else. The doctor advised me to stay away from sex workers for the duration of my trip, which I complied.
I know that HIV is more prevalent in Thailand than in the States, which has started to worry me. I will get tested but I'm giving it some time so I can be assured that the test is accurate and not have to worry further (hopefully). So, this brings me to my question. How much, if by much at all, does gonorrhea increase HIV infection assuming one or more partners are infected with gonorrhea? Of course, I could have received the gonorrhea through the unprotected oral sex which was the local clinic doctor's opinion for some reason, I don't know why he concluded that. I know that gonorrhea can increase the risk of HIV infection, but by what margin? Am I significantly at higher risk for HIV infection?
However, about a week after those incidents (they were about a day apart) I noticed pain in my testicles and penis, and I also had a discharge. I was treated for gonorrhea at the local clinic, and everything was cleared up. I was tested for both gonorrhea and chlamydia but only tested positive for gonorrhea. No more symptoms, although the rest of the week I was feeling a bit under the weather and overall generally sick. Sore throat, perhaps a light fever (I never checked my temperature), but not much else. The doctor advised me to stay away from sex workers for the duration of my trip, which I complied.
I know that HIV is more prevalent in Thailand than in the States, which has started to worry me. I will get tested but I'm giving it some time so I can be assured that the test is accurate and not have to worry further (hopefully). So, this brings me to my question. How much, if by much at all, does gonorrhea increase HIV infection assuming one or more partners are infected with gonorrhea? Of course, I could have received the gonorrhea through the unprotected oral sex which was the local clinic doctor's opinion for some reason, I don't know why he concluded that. I know that gonorrhea can increase the risk of HIV infection, but by what margin? Am I significantly at higher risk for HIV infection?
MEDICAL PROFESSIONAL
Hello and thanks for your interesting question,
We do know that STD's that cause mucosal damage - such as gonorrhoea, herpes, syphilis - will increase the possibilities of HIV acquisition by simply causing the appearance of a "raw" skin surface and facilitating blood to blood transmission.
How much it does this is a subject of some debate - but a small multiple will increase HIV transmission rates - I would think that gonorrhoea might increase the potential by a factor of 2 or so.
kind regards, Sean
We do know that STD's that cause mucosal damage - such as gonorrhoea, herpes, syphilis - will increase the possibilities of HIV acquisition by simply causing the appearance of a "raw" skin surface and facilitating blood to blood transmission.
How much it does this is a subject of some debate - but a small multiple will increase HIV transmission rates - I would think that gonorrhoea might increase the potential by a factor of 2 or so.
kind regards, Sean
I would also like to add that all the sex workers were female, and were massage girls rather than street walkers if it makes any difference.
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