South Africa

[jonny_mail]

Dear Doctor,

to be short - had sex with black girl in S.Africa originally from Zambia, safe vaginal (one intercourse), unsafe oral + some fingerplay. that's facts

emotions  - the silliest thing in my life that, however, can make me THING responsibly

already, schedule full STI screen test 2.5 weeks after incl. blood test and another one in three month

Probability? I know that probability is not 100% but what is the reason to make roulette from your life and your family?

yours, Eugene

[Edward W Hook, MD]

There is some definable risk to the expsoure you describe. The prevalence of HIV among Zambian women is about 20% and higher among those who are commercial sex workers.  If she was infected (possible), your risk from protected vaginal sex is about zero as long as the condom was on throughout.  The risk from oral sex is quite low, even though it was unprotected - less than 1 in 10,000 if she was infected, perhaps lower.  The fingerplay -no risk.  Bottom line, probably not one of your wiser decisions but the odds are still very much in your favor.

the STD testing you get at 2.5 weeks will be reliable for most STDs.  An HIV test performed at that time however will only detect about half of infections that are going to occur.  For a more definitive HIV blood test result, you should be tested at either 8 weeks (when 98-99% of infections will be detectable) or at 12 weeks when virtually all infections will be detected by the blood test.

In summary, the odds are in your favor but the exposure was risky.  You should be tested.  Hope my comments help.  EWH

[jonny_mail]

all others - negative. but again  - the test was in 12 days after exposure

i plan to re-test in 6.5 weeks and 10 weeks

[Edward W Hook, MD]

Yes, it helps.  EWH

[jonny_mail]

No Gonorrhea and Chlamydia are detected in 12 days of the exposure.
Does it make odds a bit favourable?

[Edward W Hook, MD]

It would keep you from potentially passing anything on to her as long as the condom doesn't break. You asked what the right thing to do was - I told you.  EWH

[jonny_mail]

so what about safe sex, doctor?

[Edward W Hook, MD]

That is the right thing to do.  Any concerns you have now would only be amplified in the improbable situation that she got something from you.  EWH

[jonny_mail]

Dear Doctor,

I have a follow-up question.
How should I prevent my wife (she will know the facts and risks) of potential transmission of HIV and other STI in meantime?

Regards, Eugene

[jonny_mail]

Thank you, doctor Hook

[Edward W Hook, MD]

Given your timing, there is no benefit to be had from PEP.

The reason I say there is risk is becasue most peole do not have sex with infected parters.  Your partners's chance of being infected is at least 1 in 5 or at least 20 times higher than if you'd had sex with a heterosexual woman here in North America.  Numgerically, that is increase risk.

AS for your symptoms, the ARS typically begins 10-21 days after exposure, not the next day as yours symptoms appear to have occurred.  I urge you not to worry, the odds remain very much in your favor.  EWH

[jonny_mail]

Thanks, tom

i would agree.. but I still consider other facts.. fingerplay, and i was sure I touch her vagina with my penis but did not go inside... did chances grow up?

Anywasy I have nothing else now except wait, pray and continue work.

[jonny_mail]

Doctor, it was Thu night, so about 92 hours before.
Fever starts next day afternoon, i.e. in 12 hrs, in the evening I got the local doctor who gave me Amoclav (amoxycillin) as he did not catch any symptoms accept slight fever and weakness

[Edward W Hook, MD]

No.  No benefit from PEP after 24 hours beyond expsoure. When was your exposure?  EWH

[jonny_mail]

Doctor, I am in panic. I had a flue simptoms since the next evenin after that night. Does it mean any sense, should I get this PEP now? It is still not late

[Edward W Hook, MD]

Your risk is sufficeintly low that I probably would not recommend PEP at this time. If your exposure ahd been unprotected genital I would probably recommend PEP but your less than 1 in 10,000 chance is very low, probably lower than your chance of side effects from PEP.  EWH

[jonny_mail]

thank you Doctor - it is 4th day today.
Would you recommend PEP though?