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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: HIV and AIDS
Satisfied Customers: 10337
Experience:  14 years experience in the field of Family Practice
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I'm male and had protected vaginal sex with a woman who is

Customer Question

hello,
I'm male and had protected vaginal sex with a woman who is an escort with unknown HIV status. After sex, I realized I had a small open cut on the bottom of my penis, far enough that the condom would not have covered it, our session lasted about half an hour. I am worried that if she is HIV positive, could her vaginal fluids (and HIV virus) found their way into my bloodstream through this open cut? Should I seek out the HIV PREP?
Submitted: 1 year ago.
Category: HIV and AIDS
Expert:  Anthony Bray, MD replied 1 year ago.

Hello!

You would not be a candidate for PREP which is PRE-EXPOSURE PROPHYLAXIS...

You had a sexual contact with a person if unknown status ...you could meet with your doctor to discuss PEP (Post exposure PROPHYLAXIS ) as your contact is in the past not future...

Generally PEP is advised for contacts of concern with a known positive HIV source but not advised for general unknown status contacts such as yours. The issue is related also to TIMING -- how recent was your sexual contact ?? The sooner the better as to consideration of use of PEP....

PEP is usually not advised in status unknown type contacts as the treatment does carry side effects and the benefits do need to be weighed vs risk ...

I am not saying that your case should not warrant discussion. The decision would be between you and your doctor. For your information your situation would not fit with the usual application of PEP however ...

If you are beyond 72 hours then potential benefit of PEP is decreased...

The situation seems still low risk but I can't say zero ...a single episode of vaginal sex is lower risk for HIV transmission...the broken skin would increase potential risk ...you using a condom would be in your favor ...the location of the cut sounds low on your penis and so it sounds that this area may not have been so exposed to vaginal fluids ...

So your situation seems low risk but not zero...

I would encourage you to meet with your doctor to establish a follow up plan . I think that you should be followed up and get testing in a few weeks to ensure that you have not contracted HIV....

The prevalence of HIV in your area may impact decisions ...

In general a single sexual contact episode such as described would be very low risk for HIV transmission.

I hope that this information is helpful Let me know if you have further questions or discussion I will be happy to get back with you.If my answers have been helpful and to your satisfaction then please remember to leave positive feedback Thank you and Best Regards,

Anthony Bray MD

Customer: replied 1 year ago.
Thanks for your response. I understand that the encounter places me with low risk, however upon researching the initial symptoms that individuals exposed to HIV may experience, I realized I have some of them (swollen lymph nodes in neck, sore throat, headache). Since this encounter was less than 3 days ago, I do recognize that it is likely not possible that these would be related to an actual HIV infection and more likely may be my body's response to stress/anxiety is this correct? A Registered Nurse that I spoke with advised me to monitor my symptoms and seek further medical attention if they do not subside or worsen, would this remain my best course of action or should I be seeking further medical attention right away?
Customer: replied 1 year ago.
Also, I've heard rumors after the fact that this escort is HIV positive but I am unsure if this carries any weight or if it is just smearing against her.
Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

I think in your best interest to consult your primary care doctor .....discuss details. ..you and your doctor may develop follow up plan ...your doctor may examine area of the skin disruption in your penis ...

If right at 3 days post exposure then post exposure PROPHYLAXIS might be considered but escorts status if unknown places you in different risk category than if known positive ....I agree that rumors may be most unreliable

You using condom makes it seem to me very unlikely to contract HIV...I get the picture that you had small cut near base of penis ....it seems very unlikely considering the combination of factors involved ...

I agree that this soon after the suspected exposure there is no way your symptoms would be due to HIV infection (too early )....

I agree that you likely experience anxiety....I see this commonly with scares of HIV...HEALTH ANXIETY >>> people will commonly report non specific symptoms such as fatigue , headaches , lymph nodes feeling tender / reactive ......

You may have other minor viral infection as explanation for your symptoms ...it is fall and extremely common to see viral upper respiratory infection....sore throat and tender lymph nodes would be expected with this ....

HIV conversion symptoms would be potential more at 2 to 3 weeks after so the timing does not fit with this ....

I hope that this is helpful for you.Let me know if you have further concerns.Best regards,

Anthony Bray MD

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