Seeking Peace of Mind

[kciub]

I have already submitted my situation on the free forum here on the site, and sincerely value all of the opinions and feedback I received there. I only now discovered that for a small fee, I could seek the advice from a MD (not knocking the community) to close this chapter for good.
Last weekend I bought some female companionship (United States). She started with a handjob with the hotel room body lotion (she said she didn't carry lube). She then put on a condom, was giving me protected oral sex and she spit a lot on my condom protected penis (I have read saliva weakens HIV) and after, she then sat on my penis and we had intercourse. I couldn't cum so she took off the condom off to finish me by hand. I couldn't cum, got bored,we had more sex but she put the ORIGINAL condom back on (said she only had one condom) 3-5 minutes later. I am paranoid she might have put it on inside out which my penis tip and euretha would have been in contact with her vaginal fluids . Knowing that the odds are slim she even had HIV when I returned back to the west coast (she was east coast) I actually texted her and asked if she was clean and she to my surprise replied "yes I am clean and we wore a condom".
1) Would  putting the condom on backwards be a risk assuming the side originally in her vagina was now on my penis or would the HIV being exposed to oxygen, outside the host, etc have been non-infectious?
2) Would this simply be comparable to a handjob or frottage with vaginal fluid/secretion on the hand while touching the tip of your penis?
3) Does the spit all over my condom wrapped penis, eliminate almost any chance of HIV transmission again assuming the condom was turned around or is this irrelevent?
4) Do you see any reason to stop having unprotected sex with my wife?
5) Do you see any reason to a HIV test?
Thanks again, and since I've already received awesome feedback from the community, I understand if your reply is brief.   (Like a Co-Pay at my PCP)!!

[Edward W Hook, MD]

Welcome to our Forum.  I'll be pleased to comment.  Let me first say that when I respond I always check on what was said in the community site and almost never differ in my assessment.  And, when I do differ, the differences are slight. This however is one of those instances.  When condoms fail to do their job despite not breaking it is because they are not used properly- such as people who start to have sex, THEN put the condom on or use a condom twice, inadvertently exposing themselves.  This is one of those instances.  Your risk for HIV is tiny, the risk for other STIs (like chlamydia) is slightly higher but not effectively zero as would occur if you had only used a condom, or condoms, once.  .  Most commercial sex workers do not have STIs, including HIV and STIs are not transmitted   most of the time that persons are exposed to infected partners.  Nonetheless, while lower than for totally unprotected sex, there is a slightly higher risk that you may have been exposed.  How much higher cannot be calculated.   I would suggest testing for chlamydial infection and, in the future for HIV.  would I worry, no but would I test, yes because I am a cautions person and strange stuff (rarely) happens.  

In answer to your specific questions

1) Would  putting the condom on backwards be a risk assuming the side originally in her vagina was now on my penis or would the HIV being exposed to oxygen, outside the host, etc have been non-infectious?

This, in part depends on how long it was between uses, whether there were secretions caught between folds or at the tip of the condom, etc.  Even then, most HIV, if present would have been dead or dying but again, I cannot be 100% sure.

2) Would this simply be comparable to a handjob or frottage with vaginal fluid/secretion on the hand while touching the tip of your penis?

Hard to say.  close but....

3) Does the spit all over my condom wrapped penis, eliminate almost any chance of HIV transmission again assuming the condom was turned around or is this irrelevent?

Saliva does have substances which weaken and inactivate HIV however the effect you suggest has never been studied.

4) Do you see any reason to stop having unprotected sex with my wife?

Not after your chlamydial test.

5) Do you see any reason to a HIV test?
see above. There is probably some tiny risk.  I would not freak out but I would test at some point in the future.

Hope this helps.  Next time make sure there are more condoms.  EWH

[Edward W Hook, MD]

Thanks for your thanks and for your thoughtful comments.  We would welcome hearing of your test results.  I suspect you and I both know what they will be (negative).  EWH

[kciub]

Just wanted to give an update Dr. Hook, my lab results all came back negative for Chlyamidia, Gonnohrea, HSV, HBV, HCV, and HIV.  Now I know a negative result for Hep & HIV are meaningless for THIS exposure because they were done within a week of it,but I feel much better. Being a data analyst for a profession and dissecting the cdc statistical data on infection over the past 9 days has shed tremendous light on this and my  probablities. This and in addition to the countless posts from yourself, Dr. HHH, and Teak on the community, I feel extremely confident when down the road I retest for HIV and HBV, i will pretty much undoubtably have a negative test.

Not to mention (this I can laugh at now), I went a bought a box of condoms, and tried all 12 of them on in every possible way imaginable. Since I've been having unprotected sex for the past 8 years with my wife, and knew we were negative from all infections (we haven't had sex since this exposure), I didn't realize how close to impossible it is to put a condom on the wrong way....Especially after it was removed from the penis. No way she was able to pull that off without a serious red flag going up and me remembering, because I literally couldn't do it.  Other bits and pieces of the night have surfaced with time as well. Me trying to insert my finger in her vagina and her telling me she didn't allow that, only her clitoris if I chose, and the simple fact that she wasn't having sex without a condom PERIOD, by just taking a step back and looking at that behavior tells me she was all about being protected from me (like a thousand posts on this site try to remind the anxiety stricken).

All that being said, all I have is what appears to be the common symptoms of guilt, shame, and anxiety with having my first and (with help of a mental health professional to get to the root of my problems on why I did such a thing) my last one night stand with a CSW or non-CSW.

With your permission doctor, I would like to only return to this thread after the 8 week mark to give you and the community the reuslts of my HIV and HBV tests.  I still want to get the test done for me (closure), but also to protect my wife.  The only thing I find frustrating about this site, is I've read through a lot of posts (that seem to relate to my "incident") and the original poster disappears without giving what are certainly negative test results, which just in my opinion really help a lot of "worried wells" get through the anxiety.

Thank you again Dr. Hook.

[kciub]

Thanks Doctor. I'm done bothering you, and should my results return HBV negative, I will get vaccinated.

I called her and flat asked her today again if she was clean and was tested regularly for all STI and HIV. With her being 22 years old, she swears yes and she was vaccinated as a child to attend school in Chicago, which through research, appears that Illinois started vaccinating children in 1997. So again, just looking at statistics, seems she is likely HBV negative.

[Edward W Hook, MD]

You should be vaccinated if you were not. the risk for HBV is tiny.  EWH

[kciub]

It was the LNP who put the risk of HBV in my head, and I am not sure if I've ever had the vaccine.

[kciub]

Thanks. What about HBV risk in all of this?
I went to the lab and they sent off blood and urin and will get the results back next week for the STI. The urine sample they collected and read was negative for I guess a UTI, but she did give me the antibiotics since I was already exposed and which I already took, so too late for that.

[Edward W Hook, MD]

I agree with you that the chances of infection are slim.  I would not recommend antibiotics at this time.  I suspect if you took antibiotics you'd be more likely to get side effects than to be treating an infection.  EWH

[kciub]

Well not exactly the conclusive response I was hoping for, but that's what I get.  So many "What if" scenarios in the event, I seriously doubt there was any exposure (again I'm not even sure she put the condom back on incorrectly and I do remember there not being much wetness at all).  I even attempted to "reenact" the scenario and bought a condom and it was very difficult to flip the condom whereas it felt normal (meaning I would have known it was on wrong).  All that being said, I am off to an Urgent Care in 45 minutes to get tested.  To be on the safe side, would you advise I request antibiotics today? My wife and I aren't extremely actuve sexually (have sex about once a month and she is on her period right now), and I feel in the slim chance I have Chylamidia, I could get ity handled by the time we'd be about due for sex.
Thanks Doctor.