Vaginal Exposure

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Hi Dr Handsfield,
                            after reviewing some of the boards i may not be treading new ground here but my worries abound so I feel compelled to ask. Almost 9 weeks ago had a partial exposure with a white escort in atlanta. I am black 30year old hetero and circumsized. My size cause the profalactic I was wearing to break open. I dont know how long I was exposed but I didnt notice until we changed postitons. I have no idea if she is a drug user.  I did develop a bout of gonnorea from this exposure which is what scares me. My worry is that I have had a mild sore throat for a couple weeks and peas size lymphnodes in the neck area and behind my ear near my hairline. I do suffer from dryscalp which I take ketaprozole for. Because I'm black does that put me at a higher risk for HIV especially since I did catch an std from this person? And since this was a hetero exposure what are my chances of getting HIV. Very concerened.Thx

[Edward W Hook, MD]

I predict your test will be negative.  The number is what it is.  Some people whould feel that  1 in 10,000 risk is high.  I do not.  

Also, it sounds as though you did not get gonorrhea.  

I suggest you stop taking you temperature.  You'll be fine.  EWH

[Fisk]

Thc Dr for your comments. I did have a test this morning and am awaiting results. I must admit my teeth are borderline chattering out of fear. Between the pea size nodes and the wierd texture the skin on my face has felt like i pretty much covinced myself im postive. Also the almond size node behind my ear akthough small makes me feel like there is a softball behind there. Ive grown weary of checking my temp everyday and inspecting for rashes. Its all ben too much. The gonorrhea I caught was just a guess I should have clarified since my test came back negative for both that and chlymidia oddly. But I did suffer from severe urethral itching, mild stinging after urination a very light discharge.Just a question the 1/10,000 number you describe is that a highrisk number?

[Edward W Hook, MD]

Welcome to the Forum.  Being black does not change your risk for HIV.  African Americans have higher HIV rates, in part because HIV is more common among African Americans, therefore you are statistically more likely to be having sex with an infected partner if your partner is AA.  The likelihood that your partner is also a bit higher than average in that she was a commercial sex worker who had (and gave you) gonorrhea.  This slightly increased risk is due to her other risk factors, not her race.  In your case, I would estimate your risk for HIV as being substantially less than 1 in 10,000.  I got to that figure be estimating that her likelihood of having HIV is less than 1 in 10 (a 10% HIV rate would be VERY high for commercial sex workers) multiplied by the risk of HIV form a single unprotected episode of vaginal intercourse (1 in 1000).  that she had gonorrhea increases the risk slightly but not much.

Testing is certainly reasonable but I would not be overly worried.  A test at this time, more than 8 weeks since your exposure will give you a definitive answer as to whether you became infected (which is unlikely) and provide you with peace of mind.  I would suggest just getting testing at this time to put things behind you.  

Hope this comment helps.  EWH

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Dr I also forgot to add that the escort performed unprotected oral on me .