Extremely scared of contracting HIV from my first sex experience.

[puuma]

Five weeks ago, I had sex with a sex worker in Thailand and it was my first sex experience.

(First episode) She put a condom on my penis by her mouth and did a very short ******** (about 20 seconds). Then, I had vaginal sex with her with the same condom for five minutes and I ejected.

(Second episode) She put a new condom on my penis by her hand and I had vaginal sex with her about ten minutes. I didn’t eject. I found that my penis wasn't fully erect and the condom slip, but still cover more than half of my penis. So she did a handjob while I still wore the same condom for a few minutes. Then, she took off the condom and continued doing hand job with her hand that had vagina secretion until I ejected.

It was my first experience. I was nervous and lacked of experience. So, I didn’t check if the condom remained intact.

1. Is it possible that the condom was broken in the first episode? I didn’t feel pain while she was doing a short *******, and as far as I remember, I saw my *** in the condom after ejected.

2. In the second episode if the condom was broken, would the sex worker know while doing a handjob?

3. In the second weeks after exposure, I have very subtle diarrhea for a few days, but I haven’t had any other ARS symptom (flu, swollen lymph glands, rash), Does that can be a good indicator that I don’t get HIV?

4. Now, I cannot concentrate on my study. I want to get tested next week (6 weeks after exposure) and get negative result to calm myself. But, the other side of my mind keeps asking me that if the result will not be negative, will it ruin my study? Is my fear irrational?

5. I know that the Elisa test at 6th week can be a good indicator, but not conclusive. Anyway, my exposure was in Thailand. I’ve heard that subtype A/E has a longer windows period than subtype B. So, for my case, can the 6th week test still can be a good indicator.

6. Home Access uses the first Generation of Elisa. Can it detect HIV subtype A/E at 6th week?

[Edward W Hook, MD]

Your questions have been answered  many time and only indicate that your anxiety level has surpassed your common sense.

The only way that a person can know that a condom broke is by being aware of it.  As a physician, I have no means of checking if someone did not notice that their condom had broken.  

The absence of ARS is neither here nor there.  Since the presence of absence of flu-like symptoms is a poor indicator, how could their absence be a good one?

Your risk for HIV is tiny.  Youi need to get tested to resolve your anxiety.  I will not continue to feed that anxiety by answering questions which only lead to more questions which are of little or no relevance to your situation.  No more questions please.  Questions asked will not be answered.  You may wish to take your concerns to the HIV Prevention Community although I can assure you that the answers you get there will be similar to mine.  EWH

[Edward W Hook, MD]

Your risk is low. So low that it is close to zero.  Here are the facts:

1.  A condom was used for all sex acts.  Condoms work. Had a condom broken, you would know it as they do not just leak when they fail, they break wide open.
2.  For condom protected vaginal sex your risk of getting HIV, IF your partner was infected is less than 1 in 100,000 and probably in the range of 1 in 1 million.  The risk from oral sex is even lower.
3.  There is not risk from masturbation, even if your partner's genital secretions get on you.  No one has EVER gotten HIV from masturbation.  NO ONE!.  You will not be the first.
4.  Chances are good that your partner was not HIV infected.  Most commercial sex workers, even in Thailand are not infected.  The she used a condom is further evidence that she was not infected.  Most sex workers who use condoms are doing it to protect themselves from their clients, not the other way around.
5.  Your symptoms are not the least bit suggestive of the ARS which, incidentally, is not a good way to assess HIV risk.  Most (over 99%) persons with flu-like illnesses have the flu or some other virus, not HIV.

As far as testing is concerned.  Get tested and do not worry about variant strains.  These concerns are not appropriate.  A test at 5 weeks will detect over 90% of infections acquired 5 weeks before.  In your very, very low risk situation, a negative test can be taken as assurance that you do not have HIV and will accurately predict the results of any further testing you do.  EWH

[puuma]

Thank you, Dr. Hook.

At first, after reading your answer, I wanted to stop my thread, and would not talk about it again.

Now, I'm waiting Home Access ordered from the Internet to be delivered. It's very hard time for me. Something's playing on my mind, although I know my fear may be irrational.
I always wonder if the the condom broke, replaying  the scene when I was having sex with that CSW all the time.


Can I ask you two more questions? They may be very repeated and useless.

1. Have you ever seen any HIV-infected patient who didn't know the condom broke, but just doubt if it broke?

2. Having ARS is not a good indicator that one got HIV. Anyway, I don't have ARS, can it be a good sign.