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CSW Exposure

Dear Dr,
Thank you for your assistance.

The event described below might be of no exposure to hiv.

On 13th April I had protected vaginal intercourse with a CSW which lasted about 30 minutes. I came outside of her. Went to the toilet, took of the condom, it looked fine and I through it away. Washed my penis and its surrounding areas with water and soap. And thats the end of it.
CSWs in my country (Pakistan) have a large tendency of not using condoms since the majority of clients do not want too. Maybe because its a low prevalence country.

1) Since the intercourse was longer than average, there were times where my erection lost half its strength and shortened and then got erected again. I used the same condom (Durex Extra Safe) throughout without taking it off. It did not come off aswell. Is this the proper use of a condom, when you keep the same one on even after losing some of your erection?

2) I also had a lacent prick (blood sugar) on my finger from the previous day. While I took the condom off and held it for observation, I got some vaginal secretions on my hand and finger. They were washed with water and soap afterwards. Is this a cause for concern?

3) I fell ill on the 15th day post exposure with a mild sore throat and fever. It went away after a couple of days but a mild sore throat and chest congestion are still there and a week has passed. Can these symptoms be of any concern with regards to hiv?

4)Since childhood, I have suffered from anxiety. In order to calm my nerves I would like to take the HIV DUO test. I know it is conclusive at 28 days, but how accurate will it be on the 25th-26th day? (If the symptoms are caused by Hiv, it would be accurate, right?

Regards,
Takster
6 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum. You confirm my own understanding about the low rate of HIV in Pakistan, even in CSWs who may not use condoms consistently.   To your questions:

1) This shouldn't make much if any difference in HIV risk. As long as the head of the penis and the meatus (urethral opening) are covered, protection against HIV is complete.  

2) Within hours -- maybe even a few minutes -- skin wounds are protected by clotted blood, preventing HIV access to susceptible cells.  A small wound of this sort, a day old, does not significantly increase HIV risk.

3) The symptoms of HIV can mimic those of many minor infections, and some of your symptoms are in this category.  However, HIV doesn't generally cause productive cough ("chest congestion"); usually there is no cough at all.  Also, your symptoms came on late; new HIV infections typically cause symptoms within 2 weeks.

4) There is little or no signficant difference between test reliability at 25-26 compared with 28 days.  To be absolutely certain, I would recommend you wait the additional 2-3 days to reach 4 weeks.  But if you cannot, you still can consider the result conclusive.  And you are correct that HIV tests are always positive within a few days of onset of symtpom:  if negative, it will be additional evidence your symptoms aren't due to HIV.

I hope these comments have helped.  Best wishes--  HHH, MD

Avatar universal
Thank you Dr.

Last question. All in all, was I at any risk of hiv whatsoever?

Your help is appreciated. God bless
Avatar universal
Sorry, but im suffering from anxiety. Can you please tell me if there is a chance that I had an exposure to HIV?
239123 tn?1267647614
MEDICAL PROFESSIONAL
Nobody can ever say that the risk of HIV is zero from any particular sexual exposure.  However, for the reasons discussed above, the chance is less than that of you being struck by lightning or a meteorite.  Beyond that, and my advice above about HIV testing, I can do nothing more.
Avatar universal
Ok. So, protected sex with the condom staying intact does have a risk? And vaginal secretions on a finger cut aswell? Theoretically, I can imagine but even realistically?
239123 tn?1267647614
MEDICAL PROFESSIONAL
I'm not going to keep saying the same thing using different words.  Move on.

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