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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18192
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Regrettably I had with a worker yesterday and

Resolved Question:

Regrettably I had intercourse with a sex worker yesterday and now am in total fear. I am the most paranoid person ever of catching HIV and looking for advice/peace of mind.
I received unprotected oral sex and we also engaged in protected penetrative sex (using condom) And only for 5 minutes. Obviously I don't know whether this woman has HIV but I'm scared since she is a sex worker. What's worse is that I have a minuscule cut/nick on the base of my penis from shaving which I'm not sure if the condom covered. Basically I'm finding every reason to panic.
What is my likelihood of hiv transmission?
Also I'm within 24 hours, is there enough of a case for me to get PEP or am I just being paranoid? I heard PEP can have pretty dire side affects.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.

Dr. D. Love :

Hello.

Dr. D. Love :

Please enter chat.

Dr. D. Love :

Was this miniscule cut/nick a fresh cut? Or was it from several hours before?

Dr. D. Love :

Are you there?

Dr. D. Love :

Hello

Dr. D. Love :

The risk of unprotected oral sex and protected vaginal sex is very low.

Dr. D. Love :

The risk of such encounters with an HIV positive person is 0.005%, meaning that 99.995% will not become infected.

Customer: The cut was fairly fresh yes, as in a couple of hours previous
Dr. D. Love :

Whether there is any risk associated with the nick/cut depends upon whether it was a fresh cut.

Dr. D. Love :

Was the cut still bleeding or oozing?

Customer: Not that I know of
Customer: I'm not 100%
Dr. D. Love :

If the cut had healed sufficiently that it was not bleeding, then it does not involve any risk.

Customer: Can a cut/nick heal sufficiently within a 2 hour time frame?
Dr. D. Love :

The current recommendations for PEP is that it is not typically used for people that have had protected vaginal sex or unprotected oral sex.

Dr. D. Love :

If it is not bleeding, it has typically healed enough that it does not provide an entry for the virus.

Customer: Ok...I don't think it bled at all if I'm being honest, as I said, it was a nick, it may just have created a small red mark without breaking the skin. I will need to check. Do you also think it is worth me putting on a condom just now to experiment as to whether this would have been covered or not?
Dr. D. Love :

No, because even if it was uncovered, this miniscule cut/nick would not pose any significant risk.

Dr. D. Love :

There does not appear to be a significant risk to this exposure.

Dr. D. Love :

Of course, any sexual encounter will carry some risk. The only way to completely avoid risk is to not have sex outside of a monogamous relationship.

Dr. D. Love :

But this encounter is not at a level of risk at which PEP is typically prescribed.

Dr. D. Love :

The risks noted above assume that she was HIV positive. The overall risk is less since she may not be HIV positive.

Customer: Yeah I just checked, the nick on the base of my penis is absolutely minuscule and like I said I don't recall it bleeding. There is a small cut just to the left of my penis (on the scrotom but near the penis) but this should not have had any contact with the person vaginally
Customer: And I recall no bleeding of any sort. So I should be at minimal risk?
Dr. D. Love :

These cuts do not sound worrisome. The only risk is the small risk associated with protected vaginal sex and unprotected oral sex, which are noted above.

Dr. D. Love :

So, there would usually not be PEP prescribed for this encounter.

Dr. D. Love :

Some people are so anxious that they will request PEP for encounters in which it would typically not be used.

Dr. D. Love :

But PEP would typically not be used for this encounter.

Customer: Ok. For ultimate peace of mind, can you estimate a figure of likelihood of me catching hiv. And yes that's sounds like me, awful mistake and now extremely paranoid
Dr. D. Love :

I included the numeric risks above, although these risks assume that she is HIV positive.

Dr. D. Love :

To estimate your overall risk, the above risks would need to be lowered according to the prevalence of HIV in your community, and preferably of HIV amongst sex workers.

Dr. D. Love :

Your local Health Department would usually know the local prevalence data.

Customer: Ok, thank you very much for your help. I will look to dig a little deeper but as you have said this is all hypothetical assuming she is HIV positive. And furthermore I did indeed wear a condom. Finally, when is the earliest I can be tested?
Dr. D. Love :

If testing after an individual encounter, the testing is recommended initially at 4-6 weeks and then repeated at 3 months.

Dr. D. Love :

The CDC does not recommend testing after every low risk encounter, but rather that regular testing should be done, usually annually, but the frequency can be adjusted according to the sexual pattern.

Dr. D. Love :

The testing at 4-6 weeks is typically only done for high risk encounters.

Dr. D. Love :

The current tests are very sensitive, and the average time from exposure to a positive test is 22 days, so most people are detected at 4 weeks.

Customer: Ok Thank you for your help!! I feel less paranoid knowing my risk is minimal overall!
Dr. D. Love :

Have I answered all your questions?

Dr. D. Love :

I hope that I have provided excellent service.

Customer: I think so yes......questions about the 'cuts'. Questions about PEP and its suitability to my case. Questions regarding my risk level whilst protected. I can't think of anything else that stands out
Dr. D. Love :

Very good. If we are done, please remember to provide a rating.

Customer: And yes, the information you have provided has been clear and easy to understand, thanks
Dr. D. Love :

You're welcome.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18192
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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