Risk for HIV transmission

[Negra313]

Hello Dr.,

I have a question regarding a possible HIV exposure I had and want to know my risk. I am a female and was with a man whose status I do not know. He tried to penetrate me and "poked" me around for maybe 2-3 minutes without protection but was unable to because I have not had sex for > 4 years and was very tight. A few days later, we used condoms and he was able to penetrate me but because he was so large, the condom wasn't put on properly and it only covered about 1/3 to 1/4 of his penis. We only had sex for a few minutes because he felt the condom was slipping off and he did not ejaculate. I would like to know what my risks are for these two incidences. I am especially worried about the first one because I was diagnosed with herpes > 8 years ago and although I haven't had any outbreaks in over 3 years, I have read that you can have internal outbreaks and not know it and this places you at greater risk for contracting HIV.

[Edward W Hook, MD]

Welcome to our Forum. I'll be happy to provide you with some facts and figures.  For starters, unless there is something about your partner, it is statistically unlikely that your partner had HIV. Less than 1 in 10,000 heterosexual men who do not use IV drugs have HIV.  Furthermore, HIV is not transmitted without penetration.  Thus if there was no penetration on the first encounter and if the condom covered the tip of his penis during the second (the condom oes not need to cover the entire penis, just the head), there is no risk for HIV.  

If per chance there was penetration, the risk remains low, both because of the low chance that he had HIV and because with penetration, if he were positive, the risk for HIV transmission is less than 1 infe3ction for every 1,000-2,000 sex acts.

Bottom line, your risk for HIV is low.  Your herpes does not markedly change this.  Your risk for routine STs (chlamydia, gonorrhea, trichamonas) is higher than your risk for HIV.  I Would suggest you go on an get checked for these infections.  If this is going to be an ongoing relationship, for both of you to get tested at this early stage of the relationship is a good way to create a foundation for future interactions.

I hope my comments help. EWH

[Edward W Hook, MD]

Many but not all doctors test for trich.  The test is easily done however.  I suggest you ask your doctor if you were tested.  EWH

[Negra313]

Thank you so much for your prompt and comforting response. I did go shortly after the incident and got tested for other STDs and they came back negative. I am just waiting for time to lapse before I take the HIV exam. I have a question though, you mention trichamonas, but I am not sure my doctor tested me for this. Is this something they test you for routinely if you are having and STD check-up?

Thank you again.