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Unprotected Thailand - donation 1000USD
Aug 18, 2003

I had unprotected vaginal-penile intercourse with a (possibily infrequent - hard to tell) sex worker in Thailand (Female) once. 7 days ago. I have not had sex since. After the scare of the statistics (58 HIV rate amongst sex workers and 70 chance of contraction) I got her and me tested for STDs inc HIV. (2 days after intercourse) She turned out negative on all STDs inc. HIV. I also turned out negative on all STDs. (HIV is 3 month window period so I am not surprised I am Neg). But there is a 3 month window period for her. First time unprotected..first time sex in ages (longer than 3 months). Besides contracting gonorrea (treated - cleared up in less tha 24 hours!) I feel perfectly healthy on all accounts.

1. What are my chances of contracting HIV off her if she tested HIV negative. (Bearing in mind she could be at any time in her window period)? (Thai doctors say less than 1/ very, very low chance)

2. how does getting gonorrea 3 days later affect my chances?

3. if someone is in their window period are the chances of contracting it less...if so... how much less?

4. She tested negative on all accounts of other STDs. Does this have any bearing? (I did contract gonorrea off her but she is apparently asyptomatic)

How much danger am I in from contracting HIV? I want to be realistic about my fears.

I promised someone I would pay 1000USD if she was clear of HIV. Not sure how I'm going to distribute it yet. (I am british I am in Thailand) but definitely a large proportion of it is coming your way! Please answer - from what I've read on this forum you are more than a noble prize winner - your a saint (no implication of religion or anything other than a compliment intended). Cheers Bob - you are so strong. Please answer as soon as you can...

Response from Dr. Frascino

Hello,

First off, that 70% chance figure is not accurate. It's way too high. Now, on to your questions:

1. I'd agree with the Thai doctors. 2. No, but I do wonder if you had "not had sex in ages," and you had both yourself and your sex worker partner tested and you both "turned out negative for all STD's," where did the gonorrhea come from? 3. No, actually it's the other way around. Shortly after contracting HIV, the viral load often shoots way up and a person can be very infectious. Then, the immune system kicks in, starts producing anti-HIV antibodies (which would give a positive ELISA test) and the HIV viral load then usually decreases somewhat. The higher the viral load, the more infectious an individual is considered to be. Consequently, the window period can be an optimal time for viral transmission, if someone is indeed HIV-positive. 4. Not exactly sure what you mean by this question. By the way, even asymptomatic gonorrhea should by and large be picked up on proper STD screening. 5. How much danger for contracting HIV? Well, your risk is one time unprotected insertive vaginal intercourse with a person who subsequently tested HIV-negative. Consequently, I'd say your risk is very low. Statistically, it would be less than 0.2 percent.

Hope that helps put things in perspective for you. A 3-month ELISA test will give you a definitive answer. Please know the odds are overwhelmingly in your favor for NOT having contracted HIV from this episode.

Thanks both for your very kind compliments and generous donation. We'll all be sending our best karma your way for a negative HIV test result. I'll look forward to your WOO-HOO! Good luck.

Dr. Bob



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