Risk Assessment

[Maxmax81]

Dear Dr,

Please bear with me. My English is not very good. Long story short.
3 weeks ago i had sexual encounter with a post op transgender with neo vaginal in Thailand. It started with protected oral ( I am the receiver) and then i fingered her for 3 mins or less. There's a lot of vaginal fluid. She also fingered herself while giving oral to me. She finished me off with a hand job. After 2 week of possible exposure i have low grade fever, burning feet and dry lips.

My concerned;

1) She used her mouth to put on the condom for oral sex. Is there a risk?

2) I noticed a cut on my finger after fingering her. There’s no blood at that time. Is there a risk?

3) She used her same hand to masturbate me while she’s fingering herself.  There’s vaginal fluid on her hand or maybe blood on her hand. She used as lube i think. I noticed some fluid on the shaft of my penis and urethra. I have a very big penis hole. Is there a risk?

4) Is there a difference between neo vaginal and natal vaginal fluids when come to HIV concern?

5) If she had a cut on her hand and is bleeding a little while masturbating me. What’s the risk?

6) Low Grade fever, Burning Feet and dry lips. Early HIV Symptoms?

7) Should i be tested?

Thanks in advance.
Max

[H. Hunter Handsfield, M.D.]

4-6 weeks, depending on the specific test you have.  See the thread below:

http://www.medhelp.org/posts/show/1704700

[Maxmax81]

Thanks for the reply. When is the earliest i can get tested?

[H. Hunter Handsfield, M.D.]

Welcome to the forum and thanks for your question.  I confirm the accurate replies you had on the community forum.

Thailand is one of the world's major success stories in HIV prevention.  The rates of HIV in sex workers (probably including transsexuals) is now very low -- so it is statistically unlikely your partner was infected.  Even if she was, th exposures described carried little or no risk of HIV.  To your specific questions:

1) Oral sex carries no measurable risk of HIV even when entirely unprotected.  Certainly there is no risk from applying a condom with the moutn

2,5) Cuts are sealed from HIV transmission within minutes or a few hours.  Probably nobody has ever caught HIV by fingering or hand-genital contact, even with cuts on the fingers.  No risk.

3) HIV is not transmitted by hand-genital contact.

4) I don't understand "neo vaginal".  But HIV is not sexually transmitted unless a bare penis (no condom) enters another person's vagina, rectum, or (mabye very rarely) mouth.

6) Those symptoms are not suggestive of HIV.

7) From a risk standpoint, you do not need HIV testing.  But of course you are free to do so if my advice doesn't resolve your concerns and you would feel better having an HIV test.  If I were in your situation, I wouldn't do it (and I would continue unprotected sex with my wife with no fear of infecting her).

I hope this has helped.  Best wishes--  HHH, MD