subgroup e/ the asian strain

[koreahank]

hi.  had a pretty stupid weekend.  on vacation in bangkok and one night had sex with a sex worker and had the condom break along with performing cunnilingus. and the next night having unprotected sex with a different sex worker. 

i know the m.o. on these boards is that hiv is hard to get female-male vaginal sex transmission, but i read alot about how thailand has a very high female to male transmission rate possibly because subgroup e is more conducive to transmit heterosexually, as the virus attacks langherns (sp) cells rather than needing blood (sores and the like) to transmit.  i now feel stupid for letting the window on getting the PEP close. n have there been any studies on rates of transmission in thailand / subgroup e?  i think the western studies (claims like 1 in 1500) might not be accurate.

also, i want to test as soon as possible.  would 7 weeks be fairly conclusive (at least enough to ease my mind) before getting another test at 12 weeks?

thanks

hank

[Ann]

Hank,

The unprotected intercourse (including the broken condom) was your only risk. Going down on a woman is not a risk for hiv infection - and neither is getting a blowjob.

It is true there is some evidence that subtype E is more easily transmitted during heterosexual intercourse. It is believe this subtype may more efficiently attack specific cells (Langerhans cells). These cells, in a male, are found on the inner side of the foreskin (the part that disappears when you're not erect). If you're circumcised, this shouldn't be a factor for you.

The bottom line is that no matter where in the world you have unprotected anal or vaginal intercourse, you are putting yourself at risk for hiv and the other, more easily transmitted STIs.

The earliest you should test is at six weeks as the vast majority of people who have actually been infected will seroconvert and test positive by this time. A six week negative must be confirmed at the three month point, but is highly unlikely to change.

You need to know that a correctly used condom rarely breaks. Read through all three condom and lube links in my signature line so you can use them with confidence.

Ann

[koreahank]

I'm circumcised.  wouldn't the langerhans cells also be present in the urethra?  

i know the condom breaking was likely a problem of not using enough lubrication.  the girl washed herself beforehand which probably helped her dry out. i gotta say this is the first time i've ever had a condom break on me so i find it pretty odd.

i will wait until 6 weeks and get tested.

[Andy Velez]

Anything but testing at 6 and then 12-13 weeks is guesswork. It's harder to transmit HIV from a woman to a man than the other way round and you had a single possible exposure. The odds are in your favor that you will test negative.

Get busy with other things in your life while you are waiting to test. That will make the waiting time go much more easily.

Good luck and keep us posted.

Cheers.