That result should be highly reassuring and confirms you were not infected. However, you were tested a bit early for 100% reliable results, which come at 6-8 weeks for antibody tests like Oraquick. But don't necessarily need to wait as long as 3 months for a definitive result see the thread linked below:
http://www.medhelp.org/posts/show/1704700
Hi Dr. HHH,
Thanks very much for your initial reply. I took an OraQuick test today and the results were Negative at 32 days post "incident". Would you test again at 3 months or move on? Thanks so much -
Welcome to the forum. Thanks for your question.
I wouldn't be worried about HIV. First, it is statistically unlikely your partner had HIV. The risk tends to be especially low in higher class CSWs, and most people don't lie about HIV status when asked directly. Second, even with entirely unprotected sex, menstruation raises the transmission risk modestly if at all, compared with exposure to vaginal fluids without blood.
Third, as you have experienced, genital secretions probably work their way under a condom qutie frequently; the blood made it more noticeable, but this sort of thing probably is common. Undoubtedly this is part of the reason that condoms are less effective protection against STDs transmitted by skin to skin contact (e.g., herpes, HPV) than those that require urethral exposure (gonorrhea, chlamydia, etc). Protection against HIV is considered complete as long as the head of the penis and urethral opening are covered.
To your specific questions:
1) She probably doesn't have HIV, but even if she does, the transmission risk is virtually zero from the exposure described.
2) I would not recommend PEP, and we would not prescribe it in these circumstances in my STD clinic. However, local standards vary; you could check with the Louisville or KY public health departments for their recommendations. But I imagine they would agree with me on this.
3) If I were in your circumstances, I certainly would not take PEP, and I would not feel a need for HIV testing -- and I would continue unprotected sex with my wife without fear of putting her at risk.
Nevertheless, I recommend you be tested for reassurance purposes. You wouldn't be on the forum if you weren't worried, and negative testing is likely to be important in resolving your anxiety about it (in addition to this advice). But try to stay mellow in the meantime. In the 8+ years of this forum, nobody actually caught HIV from an exposure they asked about -- and with a low risk exposure like this one, you aren't going to be the first!
I hope this has helped. Best wishes-- HHH, MD