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HIV Prevention (Expert Forum)
"Protected" sex with a Caribbean sex worker
Answered by
Edward W Hook, MD - HIV Prevention, stds
This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
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"Protected" sex with a Caribbean sex worker
by Johnboy567, Nov 07, 2008 05:41AM
I recently (7 days ago) had sex in the caribbean with a sex worker. Basically I recieved a blowjob with a (badly made) condom on and had vaginal sex for about a min also with the same condom on. there was a lot of saliva involved and when I was removing the condom there was vaginal/salivary secretions on the shaft of my penis, over the last few days I have had a sore throat. and have been feeling the need to go to the toilet, only to be constipated when i get there. otherwise ive been fine. Apparently the HIV prevelence rate on the island is 0.60% but the lady in question was a street prostitute and Im just really worried about it. Im also worried about the condom ie it was hers and not really a brand i'd hold in high asteem.
Doctor's Answer
by Edward W Hook, MD, Nov 07, 2008 06:34AM
, Nov 07, 2008 06:34AM
I'm not sure what a "badly made" condom is. Let's assume that for whatever reason, the condom you used did not work and your encounter was unprotected - you would like to know what is your risk. The answer -low. Here is why.
1. Most commercial sex workers do not have HIV. Thus the chances that your partner had HIV are low. You cannot get HIV if she was not infected.
2. Even if she were infected, the odds are still on your side. HIV is not transmitted by every exposure. In fact, it is only tranmitted once for every 1000 genital sex acts and less than once in every 10,000 oral sex acts.
Putting these facts together, the odds are very, very much in your favor that you did not get HV from the expsoure you describe. But then what about the symptoms? Answer - they are irrelevant. For starters, the symptoms you report are not suggestive of the so called "acute retroviral syndrome". Second and equally importantly, the ARS is very, very non-sprecific and it turns out that only about 1 in 100 persons with ARS symptoms has HIV. The rest have the flu or other communtiy acquired viral syndromes which is what I would be you have as well.
Bottom line, you are at very low risk. Hope this is helpful. EWH
1. Most commercial sex workers do not have HIV. Thus the chances that your partner had HIV are low. You cannot get HIV if she was not infected.
2. Even if she were infected, the odds are still on your side. HIV is not transmitted by every exposure. In fact, it is only tranmitted once for every 1000 genital sex acts and less than once in every 10,000 oral sex acts.
Putting these facts together, the odds are very, very much in your favor that you did not get HV from the expsoure you describe. But then what about the symptoms? Answer - they are irrelevant. For starters, the symptoms you report are not suggestive of the so called "acute retroviral syndrome". Second and equally importantly, the ARS is very, very non-sprecific and it turns out that only about 1 in 100 persons with ARS symptoms has HIV. The rest have the flu or other communtiy acquired viral syndromes which is what I would be you have as well.
Bottom line, you are at very low risk. Hope this is helpful. EWH
1) why is the internet filled with fairly credible medical sites that list the non specific symptoms of ARS, and upon exposure saying that if you had even mild symptoms of only a few on the list you should immidiatly get tested as years of your life could be at stake? Is this a case of better safe than sorry?
2) the probabilities that you quote of picking up HIV from vaginal sex are pleasing to read especially now as Im worried about it, but what confuses me is if your urethral membrane receptors are coming in contact with viral laden vaginal secretions why is there the huge chance of not getting it? how can so many ppl in south africa (5 million out of 35 million ppl have HIV if thats the case?
thanks for laying out the facts
The ARS as described on the internet accurately describes the syndrome but provides no context. Just as almost no one with anemia has leukemia but people with leukemia often have anemia, the ARS occurs in less than half of people who get HIV, even when they think about it in retrospect and just about everyone gets a flu-like illness once or twice (or more) a year. Some sites then take things to silly levels.
While so many people in sub-Saharan Africa have HIV (and the numbers really are staggering), the fact is that most do not. Simarlarly, most expsoures do not lead to infection BUT an awfully lot of the world's 3.5 billion peole have sex regularly. It's a numbers thing. No further on this here.
This thread should end.. Take care. EWH
The thread is over. Further questions wil be deleted. EWH