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HIV risk concern
Dr. Handsfield,
Eleven days ago, I had a single ecounter of protected sex with a stripper in a strip club that friends of mine dragged me too. Needless to say, I am nauseated by my own behavior, to the point it is interfering with my routine functioning, and thus will never again repeat it. I would like an objective medical perspective as to the risks and appropriate actions to take as a result of this nefarious encounter.
1) What is my risk factor for HIV- I have no way of knowing her HIV status, and simply can't get images of Tom Hanks in Philadelphia out of my mind. What is the earliest I could be tested and reliably ascetain my status, based on the above description of the encounter?
2) apporximately three of four days after this encounter, I noticed a small reddish dot, unraised, on the base of the penis, in an area with hair follicles. Does this sound descrptive of syphillis, and if so, does that alter the HIV risk factor?
I appreciate in advance, your kind help in this matter.
Eleven days ago, I had a single ecounter of protected sex with a stripper in a strip club that friends of mine dragged me too. Needless to say, I am nauseated by my own behavior, to the point it is interfering with my routine functioning, and thus will never again repeat it. I would like an objective medical perspective as to the risks and appropriate actions to take as a result of this nefarious encounter.
1) What is my risk factor for HIV- I have no way of knowing her HIV status, and simply can't get images of Tom Hanks in Philadelphia out of my mind. What is the earliest I could be tested and reliably ascetain my status, based on the above description of the encounter?
2) apporximately three of four days after this encounter, I noticed a small reddish dot, unraised, on the base of the penis, in an area with hair follicles. Does this sound descrptive of syphillis, and if so, does that alter the HIV risk factor?
I appreciate in advance, your kind help in this matter.
MEDICAL PROFESSIONAL
Not a problem. The fear based teaching of the sort you describe is a real barrier to both prevention and care of persons with and at risk for STDs. Try not to worry. I am confident you are fine. eWH
You are correct, that is entirely guilt-driven. I will defer to your judgement and vast experience in matters I have little knowledge of, and wait until the six week mark to have the standard anti-body test-I need to have this for my own peace of mind before I can personally ethically conduct any future relatonship. I apologize, but I can only draw on my high school sex education classes, which seemed to indicate HIV was nearly as easy to contract as the common cold-your professional guidance has given my new insight into the actual, realistic routes of transmission. Thank you for your sincere guidance and advice, and I apologize if I seem overtly paranoid and anxious.
MEDICAL PROFESSIONAL
Following a virtuallyno risk, condom protected expsoure such as the one you dewcribe,, no amount of testing or money spent is likely to demonstrate the presence of infection. While in theory PCR testing might provide results a bit sooner, how much sooner is unknown and it is not of proven value for HIV diagnosis and is not recommended. It has a far higher rate of false positive results in un-infected persons than the antibody tests which are recommended for this purpose. Paying for testing of any sort will do little for the guilt that I suspect drives your concern. EWH
P.S....We are in agreement regarding the dot, I believe that is in fact a birthmark I hadn't noticed before due to obscured location. It is certainly not an uleration, and thus I don't think typifies primary syphiliis.
Dr. Hook,
Thank you for your kind help. I am certain, in your line of work, that you encounter unreasonably anxious people on a near daily basis. I understand further that life is replete with non-zero, yet still reasonably unlikely possiblities...that element of risk must be judged and disregarded when reasonably appropriate. Still, I am nauseated that I opened myself up to such a dreadful possibility as HIV. Do you believe I should be tested at the six week mark, or should I opt for RNA viral load testing much sooner? I understand that can be attained much sooner, and I am willing to throw any sum of money down at this point for immediate peace of mind. Walking around thinking your a walking pathogen is not easy, and should I make it out of this unscathed, certainly won't be repeated. Thank you again for you excellent help, you objective medical opinion is invaluable.
Thank you for your kind help. I am certain, in your line of work, that you encounter unreasonably anxious people on a near daily basis. I understand further that life is replete with non-zero, yet still reasonably unlikely possiblities...that element of risk must be judged and disregarded when reasonably appropriate. Still, I am nauseated that I opened myself up to such a dreadful possibility as HIV. Do you believe I should be tested at the six week mark, or should I opt for RNA viral load testing much sooner? I understand that can be attained much sooner, and I am willing to throw any sum of money down at this point for immediate peace of mind. Walking around thinking your a walking pathogen is not easy, and should I make it out of this unscathed, certainly won't be repeated. Thank you again for you excellent help, you objective medical opinion is invaluable.
MEDICAL PROFESSIONAL
Dr. Handsfield and I share the forum. You got me. FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.
Your risk from a single encounter of the sort you describe is low. Most commercial sex workers do not have STDs including HIV, even if she did, had your sex been unprotected, most sexual exposures to infected partners do not result in infection and, most importantly in your case, you used a condom and condoms are highly effective for reducing risk for STDs, making your HIV risk, had your partner been infected virtually zero. There is probably no medical reason for you to need testing. If you wish to do so for your own peace of mind, at 6 weeks over 95% of HIV infections will be detected by routine tests and at 8 weeks virtually all are detectable.
As far as the dot you describe, no, this does not sound like syphilis. Syphilis causes open sores. What you describe may well have been folliculitis. Folliculitis occurs when the pores in your skin get plugged. This allows that normal bacteria that are present on just about every-one's skin to grow and cause what is essentially a pimple. Some of these just appear as red bumps which may or may not be tender while others go on to actually form pimples. In some instances, if you look closely you can see a hair coming out of, or nearby the bump- this too is typical of folliculitis). If the lesion is still there and concerns you, I would suggest having your doctor take a look. My guess is that it is not something to worry about
Hope these comments are helpful to you. EWH
Your risk from a single encounter of the sort you describe is low. Most commercial sex workers do not have STDs including HIV, even if she did, had your sex been unprotected, most sexual exposures to infected partners do not result in infection and, most importantly in your case, you used a condom and condoms are highly effective for reducing risk for STDs, making your HIV risk, had your partner been infected virtually zero. There is probably no medical reason for you to need testing. If you wish to do so for your own peace of mind, at 6 weeks over 95% of HIV infections will be detected by routine tests and at 8 weeks virtually all are detectable.
As far as the dot you describe, no, this does not sound like syphilis. Syphilis causes open sores. What you describe may well have been folliculitis. Folliculitis occurs when the pores in your skin get plugged. This allows that normal bacteria that are present on just about every-one's skin to grow and cause what is essentially a pimple. Some of these just appear as red bumps which may or may not be tender while others go on to actually form pimples. In some instances, if you look closely you can see a hair coming out of, or nearby the bump- this too is typical of folliculitis). If the lesion is still there and concerns you, I would suggest having your doctor take a look. My guess is that it is not something to worry about
Hope these comments are helpful to you. EWH
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
