HIV Risk, protected Anal Sex with CSW

[hugebychoice1992]

Hello Dr. I am a 38 year old man. I have twice had protected anal sex with a massage CSW (women) 6 weeks and 4 weeks ago. Also had protected vaginal sex 3 weeks ago with same woman.  The condom seemed to be intact after each performance,I also showered right after each occasion. About 2 weeks ago came down with cold like symptons,(stuffed nose, mild sore throat, sore armpits, slight fatique). Also no fever at all, or rash, or diarrhea. about 5 days latter, my wife came down with similar symptons. (no sex with wife for months.) My quesiton is, do I have an exposure for HIV ? Should I be worried ? Should I go get tested ? Did I just pick up a cold from someone and spread to my wife. Currently, still only have sore arm pits, not sure if this is swollen lymph nodes.I can't dectect any lumps. I spoke with the CSW, she told me she is from China, and hasn't been tested since she came to Canada.

Please Advise.

[Edward W Hook, MD]

Welcome to our Forum.  The exposures you describe are low risk for HIV or, for that matter, any other STD. most commercial sex workers to not have HIV and most exposures to partners with STDs, including HIV do not lead to transmission of infection. For HIV the risk of transmission of infection from UNPROTECTED sexual intercourse is less than 1 in 1000.  Use of a condom, as you did, reduces the risk for infection to virtually zero.   FYI, when condoms fail, they break wide open  leaving no question that they have failed.  Thus, if your condom appeared intact, it almost certainly was.  

It sounds like your symptoms were a cold and that your wife got the same illness is consistent with this.  

I urge you not to worry, these were close to no risk events.  The choice of testing is, of course yours but there is no compelling reason for you to seek HIV testing related to the exposures you have described. EWH

[Edward W Hook, MD]

I glad you chose to test.  You can now move forward. Take care.  EWH

[hugebychoice1992]

Dr. Hook, I decided to just bite the bullet and go for an HIV Test. I went to the drug store for a "Home Access Express HIV test". My result was negative, and I feel a great relief off my shoulders. Waiting for the result was the worst part. Hopefully others will follow my lead, instead of living their life, assuming they are HIV+, and constantly worrying...

[Edward W Hook, MD]

Welcome back. I'm sorry you are going through this.  Sometimes when we have a certain amount of guilt or concern about an exposure such as yours our mind can play tricks on us.  You have been seen by several medical professionals who, like me, have told you not to worry.  If this is continuuing to trouble you, you could get tested for your peace of mind (I am confident thte result will show that you did not get HIV from the exposure you have mentioned) and/or talk this throught with a trained counselor.  EWH

[hugebychoice1992]

Thanks for your repsonse Dr. Hook. 6 weeks later, I still seem to have discomfort in my arm pits, and also between my legs. I keep thinking "enlarged or swollen lymph nodes", I did go to two different doctors at walk in clinics. Both said I do not have enlarged or swollen lymph nodes, one even  sent me for an ultrasound for my armpits (axilla), which didn't require a call back.
I also seem to have an ongoing sore throat, but I would call it very mild (no pain when i swallow, just a bit of discomfort)
I know in your previous response you have advised me not to worry, but I think my mind is playing games with me, starting to think condoms failed,stuff like that. Do others incur this when worried about HIV ??
Thank your Doctor, no further questions...