You are doing a very great service to humanity. Thank you a lot for that. Here is my story.
I am a straight, uncircumcised male from India, aged 29. On March 2nd, I had my first ever sexual encounter (yes, it was a very old age to lose virginity!! :-\) with a female escort and would like you to assess my risk, please. But one major concern is that I believe all of you are mostly North Americans or Europeans, so maybe you are talking about HIV-1 (Subtype B) which is more common there but not of HIV-1 (Subtype C) prevalent in India, which as per my preliminary research is a more aggressive and virulent strain. So please assess my risk based on that fact. Following are the details of my encounter:
1. I have sucked her boobs, not so hard, not sure of any fluids from her nipples. If there is some fluid and her viral load is very high, am I exposed and if so to what extent?
2. I have French kissed her (open mouth) for 2 minutes, not sure of sores in my mouth (superficial ones, if any).
3. I have rubbed her vagina, outer part, with my fingers. Did not insert my fingers into her vagina at all. I have some chafed skin on fingers. My fingers got slightly wet with her vaginal fluids.
4. She put a condom on me and had some vaginal fluids on her fingers (from fingering herself a little bit) while putting it on and a little of it touched the head of my penis and is now covered with the condom. I thought of using 2 condoms for extra safety and put another one on myself.
5. I then had vaginal sex with 2 condoms on (with those little vaginal secretions inside the condom while putting on), maybe for 30 minutes, not continuously but on and off. I did not ejaculate but concluded the act mainly because she complained of a little burning sensation in her vagina, not sure if it is true because she was in a hurry and wanted to leave. Anyhow, I then pulled off the condom and after a few minutes washed my penis with water and mild soap. No breakage of condoms or any leaks (checked by filling water after finishing).
I thought I did it safely that night but felt very anxious the next morning and a day after visited a doctor who scared me off when I told him that I touched her vagina with my fingers which were very slightly chafed and asked me to immediately take PEP. So I was put on 2 combination drug Truvada after 41 hours of possible exposure. Later I visited another doctor for a second opinion and he said there are no chances of transmission and told me I can get off PEP. But I am however continuing on PEP, as I was so scared by the assessment of the first doctor.
So how do you assess my risk (also take note of the Virus Subtype-C but not Subtype B) for those actions individually? Is it high, low or zero? What would be the efficacy of PEP if I had a potential exposure? Is testing warranted? I have been very anxiously searching for all the available information since then and it is taking a major part of my day.
Thank you so much for taking pains to read this long post. I will remain grateful to you people.
Jim Allen:
Hiya
The sub-type makes no difference in the biological & environmental conditions required for transmission. When we answer the questions on this forum we are accounting for all both HIV 1 & 2 and the sub-types.
1. Not a HIV risk, you are an adult not an infant.
See you're concerns seems to be about sucking breast-milk fluid or maybe a tiny bit of blood, perhaps its a mistaken mistake as you may have heard these fluids are a concern during breastfeeding. Well here is the thing its is only a concern it's is only a concern in large quantities ingested by infants with underdeveloped tissue and immune systems, even at its peak for an infant via oral digestion (breast feeding) and with that exposure to the infants underdeveloped immune system, and developing tissue the transmission is about 0.00064 per liter of breast milk ingested
You are an adult, have an adult immune system, the max contact was a few drops, not liters and even if she had lactated and you drank half a pint it would still not be a HIV risk. Not even theoretical, simply no risk.
So stop worrying about new and never before happened ways for the transmission of HIV. You are not an infant.
2. Not a HIV risk, I am not even going to start on this one. forget about it.
If you beat her to a bloody pulp requiring urgent medical care or stabbed her in the mouth leaving her gushing blood and needing medical care than, before the kissing than let me know and than we can discuss it further but otherwise its not a HIV risk and there is nothing to discuss.
3. Not a HIV concern for so many reasons I am not sure where to start...
Nobody has ever even been infected with HIV from fingering, let alone just rubbing a vagina.
The fluid a woman produces when sexually excited comes from the Bartholin's glands, this is a lubricating fluid and does not have any more hiv present than other bodily secretions such as saliva, sweat or tears. Saliva, sweat and tears are not infectious fluids.
On top of that not that it matters, HIV does not remain viable outside the human body, once hiv finds itself exposed outside the body, small changes in temperature, pH / moisture levels all damage the virus receptors thus rendering it unable to infect. This is so much so and the lack of that regardless of small cuts / wounds or scratches HIV nobody has ever either sexually of from day to day contact been infected this way.
Its lacks exposure and its not an example of a direct pathway to the bloodstream or an effective route to the cells required, again going back to the start its very simple any fluids it came into contact with were not HIV infectious to start with.
4.
Her touching your penis or the condom, the same answer as Q3 above.
4 & 5 Doubling up the condom, filling condoms with water don't do that again!
Using 2 condoms over each other is not a good idea. It increases the chances of the condom breaking due to friction among other things. Thankfully it did not break this time round but don't do it again.
As for filling them with water, testing the condom after intercourse could damage the condom, as its not designed to be "reusable" or re-stressed like this after intercourse and this could lead you to mistakenly think that the condom was damaged during sex, when in fact you actually caused the damage after the intercourse by trying to "test" it with water. In short, testing the condom yourself is not a reliable way to tell you anything.
Its basically a daft myth.
Its simple HIV simply can not transmit through the intact latex or polyurethane barrier and most condom simply fail due to incorrect usage or care. (User error) When a condom fails during intercourse its shreds leaving no doubt whatsoever, now as long as this obvious issue does not happen there is no reason to presume otherwise.
I'll give some basic information on condom usage.
Do keep in mind incorrect usage does not mean it will fail however it just dramatically increases the odds. Condoms, its simple HIV simply can not transmit through the intact latex or polyurethane barrier and most condom simply fail due to incorrect usage or care. (User error). When they fail during intercourse its obvious, without doubt as in they shred.
Correct usage includes, making sure that whatever the type of condom being used, you only use approved condoms, unapproved condom can possibly fail easier, In other words check for certification mark (FDA, CE, ISO or Kitemark etc.). This means it complies with safety standards. Check the expiry date and make sure the condom is still in date.
When using condoms use lubricant, particularly with anal intercourse and use condom safe water-based lubricants this makes condoms more comfortable and also reduces the risk of breakage. – but avoid oil-based lubricants as they can weaken or break condoms.
As for putting condom on correctly, if incorrectly done it increases the risk of breakage. Place one on top of the erect penis and pinch the teat at the end of the condom before you start to roll it down the penis. By doing this you’ll squeeze out any air bubbles and ensure there is room for the semen (cum).Roll the condom down to the base of the penis.
If it's on correctly it will roll downwards easily. If you've started putting it on the wrong way or you’re not sure then take it off and try again. Even if you have not ejaculated (cum) there can still be semen (pre-cum), so it’s important to try again with a new condom. (This is mainly due to other easier to transmit STI's and if with a cis-woman pregnancy risks)
Finally if you are changing the sex act, than change the condom.
Do remember that although HIV can not transmit thought an intact condom, the levels of protection for various STIs depends greatly on differences in how the diseases or infections are transmitted. Some infections (Not HIV) are transmitted primarily by skin-to-skin contact, which unlike HIV may infect areas not covered by a condom ( Such as genital herpes, human papillomavirus [HPV] infection, syphilis, and chancroid).
--- Quote ---I thought I did it safely that night but felt very anxious the next morning and a day after visited a doctor who scared me off when I told him that I touched her vagina with my fingers which were very slightly chafed and asked me to immediately take PEP. So I was put on 2 combination drug Truvada after 41 hours of possible exposure. Later I visited another doctor for a second opinion and he said there are no chances of transmission and told me I can get off PEP. But I am however continuing on PEP, as I was so scared by the assessment of the first doctor.
--- End quote ---
Outrageous from the first doctor, if they were registered in my country I would be putting in a complaint. The 2nd doctor is correct that its not an HIV risk, move on with your life & relax what you posted was no HIV concern
Here's what you need to know in order to avoid hiv infection: Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider starting PrEP as an additional layer of HIV protection going forward
Keep in mind that some sexual practices which may be described as ‘safe’ in terms of HIV transmission might still pose a risk for transmission of other STI's, so please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and test more frequently if unprotected intercourse occurs
Also note that it is possible to have an STI and show no signs or symptoms and the only way of knowing is by testing.
More information on HIV Basics, PEP, TaSP and Transmission can be found through the links in my signature to our POZ pages, this includes information on HIV Testing
Kind regards
Jim
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Anxious!!!:
When I first tried to post my concerns, I got an alert that I cannot post due to some technical reason. I thought my message was not posted. I came back today to post a new message but was surprised to see that my message was posted and got a reply!!!
Thank you so much Jim for your detailed and meticulous explanation. It requires a lot of patience coupled with dedication and concern to go through such long posts and answer them. My heartfelt gratitude towards all of your humane gestures.
Jim Allen:
You're welcome
Anxious!!!:
Hi, I am a male who a week back had sex with a female sex worker. She gave me oral sex with a condom on my penis. After a while I inserted my penis inside her vagina with the same condom on. Due to the tightness of her vagina and her displeasure I did not thrust but just removed my penis out in a few seconds. Then again inserted for a few seconds and removed. This is my sexual encounter.
My worry is that I did not change the condom (with which she gave me oral sex) while having vaginal insertion. I am afraid that during the oral sex her teeth might have made some minute holes on the condom. Usually I test with water after the sex, but this time I did not do. Am I at risk with the said encounter. Should I get tested over this incident?
Thank you for your great service to the humankind.