Tricky: Changing Condom 2 times with a sex worker

[Mazent]

I had sex with a Sex worker (status unknown) 3 days ago. She gave me a blow job with protection, then when i wanted to penetrate her Vagina she insisted to change the condom eventhough it was intact. . Then in the middle she wanted to ride on me but then took the second condom off with her hands (was also intact), put another new one on but I noticed that she had put it by rolling it with her fingers from the inside all over my penis. I assume then that her fingers caught some of the vaginal fluids on the condom she removed. Then she rolled the new condom from the inside, made sure first that the tip has space, but this means those fluids on her fingers got inside the new condom, correct? We continued and then I took my penis out and rubbed it between her breasts, the condom was on and intact. Then I came and noticed again that the condom is intact. After that I washed only my penis with soup and water, dressed up and drove home 20 min with the bicycle nd took a shower. My questions are:
1. What is the risk of exposure generally?
2. Does my assumption that her vaginal fluids got inside from her finger tips while rolling the condom from inside correct? If so, what is the risk of getting HIV?
3. Does rubbing against her breasts with the condom that has vaginal fluids considered risky giving that my balls could have gotten some fluids from the condom while rubbing and I showered after I got home?
I'm so much scared and worried and I'd appreciate your reply!

[Jim Allen]

I read your post three times.

Nothing you mentioned was an HIV concern.

If this was your only sexual encounter then move on with your life, continue to use condoms for any intercourse and as you are sexually active test out of standard routine yearly for STI's & HIV.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider talking to your health care provider about taking PrEP going forward as an additional layer of HIV protection.

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.

Kind regards

Jim

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[Mazent]

Hi, I had sex today with a sex worker, while inside her we heard the condom breaking, immediately I pulled out and washed with soap and water.. Then she gave me a handjob with soap in the bathroom until I came (around 7 minutes). After that I peed and washed again.
I might now die or commit suicide because I am scared to death...
Should I get worried of HIV? Should I go to the hospital and ask for PEP? Please help if you know this means the world to me....

[Jim Allen]

You could consider PEP. PEP is a course of medication that aims to prevent HIV taking hold, it's highly effective when started within 72 hours post exposure, although, some clinics and hospitals will not prescribe it after 48 hours.

If you start PEP then test to confirm your HIV status six weeks after finishing PEP with a blood draw (lab) HIV antibody test. A non-reactive result at that time would rarely change, and retesting at three months is generally unnecessary.

Whilst you are at the hospital getting PEP, please let them know that you are feeling suicidal. These are professionals, and they are there to help you.

[Mazent]

Hi again and many thanks for all the support you're giving here!
Update: I went to the ER here and they said that I might consider taking PEP, but not necessarily.
I decided to go for it. They gave me 2 tablets of Biktarvy 50mg (1 per day) and asked me to visit a HIV clinic tomorrow to discuss further and to get the full course. I would need though to talk to my Psychotherapist about combining this PEP with the antidepressants I'm already taking (Sertralin + Mertazapin), but should ask the hiv clinic tomorrow.
Not sure if the PEP would have nasty side effects that might last beyond 4 weeks... The doctor couldn't answer this question... Any idea if the course might really damage my body after having taken it in full?
Regards

[Jim Allen]

Hiya,

Presume you mean mirtazapine and sertraline, so the potential risk includes serotonin syndrome.

As for the HIV meds, I suspect there are no flagged interactions. Still, do ask the HIV clinic or the hospital pharmacist to confirm if there would be any major interaction concerns with your current treatments, although I am surprised the ER didn't check for you before prescribing it...

Anyhow, you had a potential risk and started PEP; you should not expect any issues from PEP except for settling in as it's a very mild and modern combo; not only that, but it's a short duration.

Stop having sex... I usually would never recommend that to anyone, but if you are not mentally ready to have sex or deal with the consequences of sex without the risk of self-harm, then avoid sex for now until you are ready; instead, focus on your mental health and consider working with a qualified psychiatrist (not a psychotherapist)