Transexual exposure and HIV Risk and paranoid

[Dancezar]

Hi Doctors,
Edward W. Hook and Handsfield H.Hunter,

First I would like to thank the forum and say That I have great admiration for the work of you All These Years of study, are the best.
My case is as follows and has plagued me and making me insecure.
I am from Brazil and am a 29 year old male. Last sunday I met a 22-year transsexual prostitute . Their status is not asked (serology unknown), was my only and last meeting of this kind. My presentations were receptive and insertive unprotected oral sex with very little pre cum, a few drops only lasted about 20-30 seconds, no ejaculation. but I had a herpes healed on the outside of the mouth lower lip but dry and healed Already, Already she was about 7 days. Finger in my anus and my in it. Mutual masturbation (I her and she on me). Protected anal fri. I was the insertive partner only. Afterwards I checked the condom for any sort of damage. It was intact.I would like for you to analyze These Risks and let me know how high are my Risks Given That transexuals Probably have a higher likelihood of HAVING HIV. I have a wife and son and I am distraught and desperate with this situation. I gotta go do a test run, can be infected? Can I have sex with my wife without a condom . Please help me. Thanks for everything.

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to provide some information which I hope will be helpful to you.  Overall, this was a low risk exposure.  As I understand it, Sunday (5 days ago) you had a single encounter with a transsexual of unknown status which involved- giving and receiving oral sex, inserting fingers in each other's rectum (yours in hers, her in yours), mutual masturbation and protective rectal intercourse (you were insertive).  If I have missed something, please let me know.

Here is my assessment.  

Your partner.  While the rate of HIV is higher in transsexuals, most transsexuals still do not have HIV. thus chances are your partner was not infected.  If she was not, there was no risk at all.  If she was, as explained below, the risk is still very, very low

Unprotected oral sex:   The quoted figure for HIV risk, if one has oral sex (giving or receiving) with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  It is certainly an incredibly rare event and probably not something to worry about.  that you had a healing oral herpes lesion does not change this- still virtually no risk.

Mutual masturbation (including insertion of your finger in your partner’s rectum or her inserting her finger in yours)- no risk at all.

Protected rectal sex.  Condoms work- no risk.  If your condom appeared intact, it did not break since when condoms break, they break wide open.

Summary, this was an almost no risk event.  I would not worry and personally would not even see a reason to test if I were you.   In the future however, it would be good to ask partners their HIV status.  EWH

[Dancezar]

Ok Thanks for all your attention and quick responses. Sorry to tease him. I'll try to stop thinking about it a bit and return to live. You and Dr. Hunter are wonderful people.
Thanks

[Edward W Hook, MD]

I have nothing more to say.  you are over reacting.  This thread is over.  EWH

[Dancezar]

I read so much about testing and noticed many cases of false positive that I was in panic! What is the reliability of the test after 60 days of exposure?

[Dancezar]

Hi doctors,sorry to disturb, I am very worried. After 7 weeks of exposure described above, presented reddish throat, no fever, I went to the doctor and found I think pharyngitis. (Said to be ignited). Before this exhibition already, presented this sore throat, was allergic, also without fever. I went back to get very worried. A. It's time to take the test? 2. What results can I expect? My wife today also showed a bit of a sore throat. 3. I have gone for it? 4. or we can be really acute? Relationship I had with her three times, after about 10 days of my exposure. Help me please.

[Edward W Hook, MD]

No this is not a finding suggestive of recently aquried HIV.  EWH

[Dancezar]

Dr. Hook 45 days after my exposure, I had no symptom of ARS, but today I noticed a leak in my anus. There may be some relationship with acute HIV infection? I had no fever or swollen glands, nothing. I'm worried! Sorry to bug you again. Thank you

[Edward W Hook, MD]

Your exposure was so low risk that some would suggest that no testing was needed.  Some people wish to test even though they have little risk.
A test at three weeks would detect about 65-70% of recently acquired infections but not all.  For defintive results from a rapid test, you need to wait for 8 weeks after the event.  At that time the results would be definitive.   EWH

[Dancezar]

Sorry my english is very bad. A quick test negative after 3 weeks and 2 days. It can be conclusive? For the exposure was low risk as mentioned above case! I should not worry anymore? Thanks for everything, there will be no more questions.
Thank you.

[Edward W Hook, MD]

I do not understand your question. EWH

[Dancezar]

Please answer my question .

[Dancezar]

1. A quick test with 21 days ja ja detect infection? and could be permanent? 2. Only with this my exposition which the probability of giving a negative review? 3. Dr've had some patients report having only done oral sex without ejaculation and have done the test and come back here and say it was positive? 4. I am very worried increasingly anxious, confused with so many informations about oral sex, had told me not to worry and not have reason to take the test, but now said to do and not have relations until the result! 5. Thanks for the patience of having to get advice and answer questions as often repeated, insecurity and anxiety end up with us, and sometimes a word relieves anxiety. Thanks for everything.

[Edward W Hook, MD]

With all due respect, I have provided you with the figures regarding your risk- they are close to non-existant.  You however are the one that has to think about how to use this infromation.  If you cannot keep from worrying that even your tiny risk may lead to infection, then do no have sex with your wife until you know you are not infected through a definitive test using either a DUO test at 4 weeks or a regualr antibody test at 8 weeks  EWH

[Dancezar]

Makes 20 days of the episode and I can not stop thinking about it, I had relations with my wife 2 times after exposure, and I'm so in shock to think that I may have infected her, only 20 to 30 seconds of unprotected oral sex with a transexula where there was no ejaculation and whether there were about 3 drops of pre ejaculate. I am desperate to have contracted HIV! Not presented any symptoms yet. Help me.

[Dancezar]

Ok Dr. Edward thanks for attention !