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Ken
Ken, Postgraduate doctor
Category: Medical
Satisfied Customers: 6559
Experience:  Working as a Doctor who Cares since 2001.
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Regrettably and shamefully I had with a worker

Resolved Question:

Regrettably and shamefully 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 2 hours previous to the episode which I'm not sure if the condom covered. One on my penis can barely even be classed as a cut, think i just nipped the skin and made a red mark as I dont remember any blood and it doesn't even appear to have any 'scab-like' appearance....however there is a small cut that is located on my scrotom, very close (basically beside) the base of my penis which obviously wouldn't have been inside the vagina but may have touched it, I'm not entirely sure, would this count as risk?

Also because these cuts are small like I said, would 2 hours provide enough time for them to 'heal' enough to form a barrier against infection if I was exposed? As I said i have no recollection of any bleeding etc but they are still present which is a worry.

Also today (the next day) I've awoken to feeling lethargic and I have a sore throat...could these be early symptoms?

Basically I'm finding every reason to panic.

What is my likelihood of hiv transmission? Again this is hypothetical because the lady may not have HIV but being a sex worker the worry is always there. The lady clearly stated she never had penetrative sex without using 'protection'. Furthermore, I know you can't really tell if someone has HIV by appearance but from what I remember she seemed well, e.g. no obvious symptoms such as fever or rash.

Also I'm within 24 hours, is there enough of a case for me to get PEP or am I just being overly paranoid? I heard PEP can have pretty dire side affects.

Basically after this dreadful episode, I'd like reassurance as to whether I'm panicking over nothing or whether I have genuine concerns over a 'high risk exposure'
Submitted: 3 years ago.
Category: Medical
Expert:  Ken replied 3 years ago.
Hello,

I am Dr Ken and I will be helping you today.

I do understand your anxiety and fear.

Let me explain a bit- HIV transmission occurs when there i8s exchange of bodily fluid {blood, semen or vaginal fluid}. Penetrative sexual act puts you at more risk as compared to oral sex. I am happy that you used condom. It prevents transmission. Mild or slight cut two hors back must have formed blood clot over the wound if any. This acts as a barrier in transmission of the virus. If it would have been fresh wound with blood oozing than it would have worried me.

HIV transmission risk increases if there is fresh bleeding or sore in the oral cavity of the partner. This does not seem to be there in your case.

In nutshell - There is very low risk of transmission of HIV with oral sex {mild cut two hours old}. The risk is very low too with use of condom {only there is the condom breaks - did not happen with you}. If I were you - I would not worry and move ahead in my life. Forget the incidence.

Best
Customer: replied 3 years ago.

Hi Ken,


 


thanks for your answer, a lot of what you are saying is very reassuring.


 


As I explained I don't recall any bleeding/oozing on the cuts, there is a cut which is on my scrotum which is probably the worst of the 2 cuts (the one on my penis is not bad, although neither is this one), basically right beside the base of my penis...obviously this would not enter the vagina and would not be covered by the condom....however there it may have rubbed against the vagina during intercourse, would this count as risk?


 


Also, how effective are condoms at protecting against HIV?


 


and the symptoms I have experienced today: tiredness and minor sore throat, could these be symptoms of infection as early as the next day?


 


And finally, do you think it is not worth my while to get PEP treatment then given that my risk is small?

Expert:  Ken replied 3 years ago.
Condoms are very effective in preventing HIV transmission. Minimal risk is due to - improper use/ break.

I would not consider the symptoms from HIV. Acute HIV symptoms take one to two weeks to show up. They will not be seen the next day for sure. Also - Symptoms do not diagnose HIV {even if they are seen a week later}.

Rubbing of two hour old cut on vagina do not seem to carry risk {as clot will prevent any transmission}.

I do not see a need for PEP treatment in your case as - sex worker did not have proved HIV infection and you did not have unprotected act.

Best

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