Protected Tranny Sex - Australia

[userr2011]

About 1 week ago I had protected sex with a tranny in Australia. She was foreign (south east Asian, but spoke English decently) and it was not at a licensed venue, although she lives in a nice suburb in a decent apartment that was very clean and full of soaps and oils for her to give massages.

The encounter consisted of a few minutes of protected oral (not worried about this), followed by a couple of minutes of protected anal (me giving, her receiving), when changing positions she then said she wanted to change condoms on me, which she did. I was drunk and do not properly remember the act of her taking off the old condom and putting a new one on.

We then had protected anal for a few more minutes, she said she wanted to take off the condom and not me, which she did.

I have spoken to her several times since in which she has told me numerous times she has no HIV and no other illnesses and that she herself is the one who was putting herself at a risk, not me. She said she doesn't drink, do drugs or anything else and is very clean. She also said that neither condom broke and she just wanted to change after the oral and initial anal contact.

A couple of days ago I noticed a bump on the groin area near the penis base. I have pulled a couple of hairs out from there recently and do not know if the bump was already there. It's a kind of pimple/boil like bump, I have popped it a couple of times where puss and a little blood came out. I should note that I am quite prone to ingrown hairs.

My anxiety has lessened but I still think about it a lot. I think it stems from the fact that I was drunk and don't remember properly about the condom changing and also how disgusted I am with myself for partaking in this act (I am straight with a girlfriend) and putting myself in a potentially risky situation. Also the pimple worries me.

I posted on the free forum but thought I might as well post here as well for further peace of mind from a professional. Should I get tested?

[userr2011]

Just an update (I do not expect a response or it to change your opinion but it helps me to write it anyway).

I spoke to her on the phone and she said she was tested 6 months ago and definitely does not have HIV. She said she does not have many sex partners and would never allow a broken condom. This conversation alleviated my anxiety briefly. It came back however.

It's been 9.5 days and I have no symptoms other than extreme anxiety even though I know I have no risk. I started getting feelings of depersonalization last night which I blame on the anxiety. Hopefully the 4 week test will alleviate this.

Writing this has helped me, thankyou.

[Edward W Hook, MD]

You keep asking the same questions again an again.  These will be your last answers:

1.  Yes

2.  A combined HIV p24 antigen/HIV antibody (DUO) test will provide definitve results at 4 weeks following your exposure.  A standard HIV antibody only test will provide efinitvie results at 8 weeks

3.  Correct.  Of course it appears that neither was the case.

Further repetitive questions will be deleted without comment. This thread is over.  EWH

[userr2011]

Thanks again dr.

1. So you think it's ok if I have unprotected sex with my gf?

2. What's the soonest I can get tested and the method and accuracy of such a test if I can face getting tested?

3. I understand my odds are only 1 in 200 even if condom broke AND she was HIV+?

[Edward W Hook, MD]

At this time, the probelm is apparently more related to your anxiety than to risk.   This was a low risk exposure.  I explained in detail why this is the case.  You need to figure out how to deal with your anxiety/guilt given both her reassurances an mine.  If you cannot do this by yourself, then you should seek the help of a trained counselor or other mental health professionsal EWH

p.s.  A CSW is a commerical sex worker.  It sounds as though money was exchanged as part of the interaction.  EWH

[userr2011]

Thank you for your reply Dr. Unfortunately your post did not alleviate my anxiety and I need to clarify a couple of points:

1. I don't know what you mean by commercial sex worker, the encounter took place in her apartment after I saw an ad in the local paper. She primarily gives massages. She is not a street walker and even warned me to stay away from street walkers. It was in a nice suburb.

2. We DID change condoms after 1 mins oral + 2 mins anal, then change, then 2 mins more anal. I have a bit of a hazy memory of the changing of condoms is what I am saying. This is my main point of concern. I DO remember thinking at the time "why is she changing the condom" which I doubt I would have thought had it been broken (it was hours since my last drink and I was feeling quite fine at the time).

After the second anal she said "do not take the condom off, let me do it".

3. After my first text message to her she said she is very clean with no diseases and that we did nothing unsafe. I messaged again saying I am worried and she said she is clean and condoms didn't break.

I messaged a couple of days later and she called me saying that she has no HIV or anything and if she did then she would not be doing the job she does and could not do that to another person. She also said she is the one more at risk being the receptive partner and herself is very worried about STD's. She even said she does not drink or do drugs and that I will catch diseases from street walkers, not her. She also said "did I look sick or have any lesions or anything on my skin? I don't" which I guess isn't particularly helpful but I'd like to mention it anyway.

I still messaged her again the day after and she said my problem is mentally and the condoms didn't break and she only changed because she wanted a new one after the oral (even though we had had a minute or 2 of anal with it). Unfortunately I messaged again and she said I have to leave her alone and I keep asking the same q's and my problem is mentally and that she'd notify her boyfriend if I kept asking her the same q's.

I have been to a couple of female prostitutes at licensed venues and had NO anxiety post those events whatsoever. I had no girlfriend then so maybe it's subconscious guilt?

Anyway I'm still having anxiety issues with this, especially when alone or when not in a great mood. This anxiety is probably clouding my rational judgement of the event?

After reading this can you provide any further reassurance or advice?

[Edward W Hook, MD]

Thanks for your question and, in particular the clarification since it was a bit hard for me to follow what you meant the first time.

To summarize:
1.  Unlicensed transsexual partner.  I presume she was a commercial sex worker although you did not say this.  As such statistically there is a far higher risk that she has HIV than if she were licensed.  HOWEVER  she said repeatedly she does not have HIV.  This makes her being infected less likely since most people do tell the truth.
2.  Protected oral.  I agree, no risk.
3.  Protected rectal.  Again, no risk as long as the condom was intact and I suspect you would have remembered if it had broken. That you did not change the condom between the 1rst and second episode does not change this.  It was still safe as long as the condom remained intact. The reason that we recommend changing condoms between acts is that there is a higher risk of breakage if you don't change.  Your condom i not break, therefore still safe.
4. Pubic "bump".  This sounds like folliculitis.  Folliculitis occurs when the pores in your skin get plugged.  This allows that normal bacteria that are present on just about every-one's skin to grow and cause what is essentially a pimple.  Some of these just appear as red bumps which may or may not be  tender while others go on to actually form pimples.  Not a manifestation of HIV.

So, should you get tested?  Nothing you mention makes me particularly worried that you acquired HIV from the encounter you describe.  That said, there is no harm from testing at some point as screening (testing in the absence of symptoms) because you have had new and perhaps multiple partners over a period of less than a year.  As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).  In the meantime I would not worry.  EWH

[userr2011]

"We then had protected anal for a few more minutes, she said she wanted to take off the condom and not me, which she did. "

Sorry I should clarify that by this I mean after the second bout of protected sex was over she told me not to take off the condom as she wanted to do it (I assume to inspect it).