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Had sex with a sex worker. Ejaculated inside the condom and had oral sex. Having pimple at pubic area. Chances of contracting HIV?

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HIV AIDS Specialist
Practicing since : 1974
Answered : 2516 Questions
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Dear Dr.
I visited a sex worker in Mumbai, India. I was under influence of alcohol. What I remember is that following things happened. She touched my penis, she licked my balls and lower part of my penis. I then asked her to put a condom which she did and then she gave me a oral. I ejaculated inside the condom. I then removed the condom. I got very scared and I checked her mouth immediately and could not see any visible blood. I didnt checked behind the lips though. There was also a small pimple kind of thing (not bleeding) at my pubic area. The girl's saliva may have touched the pimple. Next day another pimple kind of thing grew near that which I squeezed and washed. Both the pimples are dry now.
1) What are my chances of catching HIV assuming that the sex worker is HIV positive
2) I read that saliva do not cause hiv transmission, I have also read that saliva contains high concentration of HIV during window period. So assuming that girl is in early stage of infection and her saliva touched my penis and pimple, am I at risk?
3) She licked my balls and lower part of penis which was not covered with condom and there were some scratches (not bleeding) on that part of my penis. Does this pose any risk?
4) Next day in the morning I spotted a red dot on my shirt and I suspected that it could be blood. There was no other spot on any other clothe. Assuming that spot was blood and possibly of that girl (may be from mouth or any where else). Am i at risk?
I am 100% sure that there was no vaginal and anal contact at all. Only contact was girl's hand and mouth with my penis and my penis was covered with condom while she gave me oral. Though she licked my balls and lower part of penis which were not covered.
5) Please tell me if there is a real need for HIV testing. I am very scared.
6) Are there pimples any sign of STD?

Posted Sat, 7 Sep 2013 in HIV and AIDS
 
 
Answered by Dr. S. Murugan 1 hour later
Brief Answer:
Negligible risk for HIV, Genital herpes likely

Detailed Answer:
Hi,
Welcome to XXXXXXX
Thanks for using XXXXXXX

1. Your risk towards HIV is almost nil.
2. Salivary concentration of HIV is not sufficient to cause infection even if you were having pimple at that time.
3.Once again salivary concentration of HIV is not sufficient enough to infect anybody through skin over the base of penis and testicles even if there was an abrasion.
4.Stains of blood from an infected person touches over the skin of another carries only negligible risk for HIV.
5. There is no absolute need for HIV test to you. Even then having a HIV test and seeing the negative result will relieve unnecessary mental tension.
6.A rare possibility of Genital Herpes may be there apart from some other non-venereal skin conditions like folliculitis etc. Genital Herpes is once again a self limiting STD. Nothing much to worry about the same.
Consult your physician for further help.

Dr Murugan
Above answer was peer-reviewed by
 
Follow-up: Had sex with a sex worker. Ejaculated inside the condom and had oral sex. Having pimple at pubic area. Chances of contracting HIV? 29 minutes later
Thank you for your reply. Is it true that hiv concentration is high in saliva during initial stage of infection? If it is so, assuming that girl is in initial stages of infection, her saliva touching pimple and penis pose any risk? Also though I did not saw any blood that day, assuming that a drop of that girl's blood touches my penis or pimple, what is my risk? I am very scared to go for testing, please tell me if there is any real need for hiv test in my situation. Would you recommend this under these circumstances to your patients.
 
 
Answered by Dr. S. Murugan 2 hours later
Brief Answer:
Negligible risk for HIV, test recommended.

Detailed Answer:
Hi,
Welcome back.
It is true that HIV viral load will be very high during early stage of infection before sero-conversion (before antibody formation) takes place. Then only it came down slowly and reaches in a set point.

Even during this early infection also, salivary HIV concentration will not be adequate to produce a new infection. Even if we consider the girl was HIV positive and her drop of blood had come in contact with the base of penis or a pimple on it carries only a negligible risk towards HIV.

Even though it carries a negligible risk and a HIV test is practically not indicated, I will try to explain my patient patiently and try to convince him to go for a test to see a negative result and to relax thereafter from the mounting mental tension.
Everyone who have some sort of risky exposures or multiple partners are requested to go for a HIV test to confirm that they are uninfected.
Dr S.Murugan
Above answer was peer-reviewed by
 
Follow-up: Had sex with a sex worker. Ejaculated inside the condom and had oral sex. Having pimple at pubic area. Chances of contracting HIV? 44 minutes later
Dear Dr.

I do not want to go for HIV test if there is no risk. Can I skip the test and move on? There are currently no symptoms also
Am I taking a risk with my life by doing this?
 
 
Answered by Dr. S. Murugan 27 minutes later
Brief Answer:
Need no HIV test as your risk is negligible

Detailed Answer:
Hi,

If you can get away from your mental tension without seeing a negative HIV test, then you need not go for a test as you have a very negligible risk towards HIV.
Dr S.Murugan
Above answer was peer-reviewed by
 
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