I'm writing to you in a state of absolute disgust with myself. I'm 29 y/old white male from South Africa.
Health excellent. i've been in a monogamous relationship, and unfortunately have HPV. This all as background.
5 days ago I went to a bar and got horribly drunk. I ended up at a brothel. got into a hot tub with 2 white female sexworkers. That is all I could remember. I retraced my steps back the next morning by looking at transactions on my credit card. I went back to this place and asked to speak to the ladies in question. They remembered me as I was apparently quite obnoxious. Only one was there, and she tried to assure me that we did not have any sexual penetration. Apparently we only fooled around in the hot tub and later on the bed. (all approx 40 min). Unconvinced, I went back again the following day and asked the receptionist to put the question to the ladies again. Same answer. We only fooled around. No sex, that they would always insist on using protection, and that they get tested regularly.
5 days on, i'm convinced of swollen nodes in groin, tender testicles, urge to urinate frequently (>8 times per day). No discharge. No redness, no foul odor. (yet).
I suppose I can't place any reliance on the word of the two workers, and should assume worst case scenario. 96 hours after the exposure I started with PEP.
My questions to you as STD/HIV expert:
Having HPV (no physical symptoms of this ever), does this increase my risk of contracting HIV (other std's)?
Assuming unprotected vaginal penetration (not sex since I don't think I had the attention span at the time), what are the odds of contracting HIV?
When should I expect to start seeing any additional symptoms in groin area i.e. redness, discharge?
When should I go for screening?
Is it worthwhile continuing with the PEP for HIV, being 96 hours after exposure?
Thank you for your post and welcome to our forum. Here are your answers:
- Having HPV (no physical symptoms of this ever), does this increase my risk of contracting HIV (other std's)? NO, IT WOULD NOT, ESPECIALLY IF YOU DO NOT GENITAL WARTS.
- Assuming unprotected vaginal penetration (not sex since I don't think I had the attention span at the time), what are the odds of contracting HIV?
ASSUMING THAT IT DID HAPPEN AND THE LADY WAS HIV POSITIVE, THE ESTIMATED RISK TO YOU WOULD BE LESS THAN 0.1%; NOT KNOWING THEIR STATUS, THE RISK WOULD OBVIOSULY BE LOWER. HOWEVER THE INCIDENCE OF HIV IN SOUTH AFRICA IS HIGH.
- When should I expect to start seeing any additional symptoms in groin area i.e. redness, discharge? IF YOU HAD CONTRACTED AN STI CASUING URETHRITIS, THE SYMPTOMS OF DISCHARGE AND PAINFUL URINATION WOULD NORMALLY APPEAR AFTER A WEEK OR SO. HOWEVER ABSENCE OF SYMPTOMS DOES NOT ALWAYS MEAN ABSENCE OF INFECTION.
- When should I go for screening? FOR THE COMMON INFECTIONS LIKE CHLAMYDIA AND GONORRHOEA AFTER 2 WEEKS OF THE INCIDENT; HIV DUO TEST AND SYPHILIS TEST AFTER 4 WEEKS. YOU COULD ALSO HAVE A PCR RNA TEST FOR HIV AFTER 10 DAYS. HOWEVER BECAUSE YOU HAVE STARTED PEP, NONE OF THE HIV TESTS ARE GOING TO BE RELIABLE AND THOSE WINDOW PERIODS WOULD ONLY APPLY AFTER YOU FINISH TAKING PEP.
- Is it worthwhile continuing with the PEP for HIV, being 96 hours after exposure. IT WAS A BIT TOO LATE TO START IT AND I WOULD NOT HAVE RECOMMENDED IT, BECAUSE OF THE RELATIVELY LOW RISK OF A SITUATION WHERE YOU ARE NOT EVEN SURE IF THERE WAS PENETRATION. THE DECISION IS OBVIOSULY YOURS AS YOU HAVE ALREADY STARTED IT AND IT WOULD MAKE SENSE NOW TO FINISH THE COURSE. AN ALTERNATIVE WOULD BE TO GET THESE LADIES TESTED AND IF THEY ARE NEGATIVE YOU COULD STOP PEP SOONER.
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