HIV Transmission?

[ndistress26]

Doc

I am a 26 yr old male. Active and Fit. Circumcised with no open sores or cuts on my penis. No STD's to my knowledge. No drug use. No tattoos. Regular Bi-annual HIV tests for work are negative. I always practice safe sex and have had very few sexual partners. With that said...

6 days ago I stupidly engaged in a sexual encounter with a prostitute of African descent in a German brothel (1 hr. south of Frankfurt). Her HIV/STD status is unknown. She performed oral sex on me with a condom for 3 minutes then we continued on to vaginal sex with a water based lubricant. I am unsure if the condom was effective the entire time, say 80% confident. German brothel workers, to my knowledge, are fairly consistent with condom usage. I even remember at one time her reaching down to make sure it was still in place. Intercourse lasted 10-12 minutes with no ejaculation. No visible blood

What is the risk of transmission given the situation described above?...and if you don't mind, what would the risk level be if the condom broke or became displaced? Should I request a earlier HIV test? So far no symptoms. Do you know the rates of HIV co-infections with STDs?...I could look for herpes fairly early.

You're doing a great job giving honest to the point advice. Thank you kindly.

[Edward W Hook, MD]

Your test result is simply additonal confirmation of what you have already been told, this was a no risk exposure.  Worrying about symptoms is a waste of time from all perspectives.  EWH

[ndistress26]

Well Doc, I decided to get tested for my own peace of mind; not to go against your advice.

2nd week post possible exposure hiv 1/2 antibody test was non-reactive. Since it was 4 months since my last HIV test, I decided it was smart to establish a baseline.

4th week post exposure hiv 1/2 test was drawn today.

I know everyone says no one should be diagnosed by symptoms alone; but would a LACK of fever, rash, sore throat, and significantly swollen lymph nodes after 28 days be a positive indication?

Happy Easter. Thank you again for any information or advice.

[ndistress26]

Thanks doc. That 20% unknown creates 100% of my anxiety. I appreciate your response.

[Edward W Hook, MD]

Welcome to our Forum.  You are not the first and will not be the last to have these sorts of questions.  My sense is that the exposure you describe is probably no risk for HIV or, for that matter other STDs.  I believe that most licensed brothels in Germany require their employees to have regular testing and that they do not employ person with known HIV.  I also suspect you can call the brothel and ask them this question.  We have had other clients who have done this.  

But, what if........    The encounter you describe was, I believe, entirely condom protected.  When completed, the condom was intact.  This means that you were not exposed since when a condom fails, they break wide open and do not just lead "a little".  Condom protected sex is safe sex.  No reason for concern.  No need to pursue earlier testing for HIV or for other STDs unless you need to do so for your own peace of mind.  From what you say, you are not at risk.

BTW, congratulations on your commitment to safe sax and regular checkups, I encourage you to continue to do so.  Hope these comments are helpful.  EWH