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HIV testing and PEP

Jan 19, 2010

Hi Doc,

I had sex with Russian prostitute twice during the same night in Bangkok. First time, the condom had stayed on till the end and I had taken it out safely myself but during second intercourse her vagina was a bit dry and hence, because of the pressure I believe the condom broke. I did not realize this during the intercourse which lasted for almost 5-7 minutes. I had ejaculated inside her and when I took out the penis it was mostly dry. I immediately washed my penis with soap and shampoo 5-6 times to avoid any infection. She assured me that she does not have any problem I am little bit hesitant to believe her. Its been 24 hours since then and I don't feel anything awkward till now.

I am leaving Bangkok in a couple of days. Please advise if I should go for a HIV test in Bangkok and start taking post-exposure HIV prophylaxis medicine to minimize chances of spreading the infection. I live and work in a Middle-eastern country where I don't want to go for testing as it has very strict deportation laws regarding HIV positive people.

What is the best time window to detect and minimize the chances of spreading the HIV infection and should I take the PEP medicine immediately even if the initial results test negative or should I wait longer?

Response from Dr. Frascino


Another banging cock in Bangkok question? Yours is at least the fifth one tonight. Doesn't anyone go to Bangkok to see the elephants or enjoy the cuisine anymore?

The CDC estimates the per-act risk for acquiring HIV from unprotected (or broken-condom) penile-vaginal sex with a partner confirmed to be HIV infected to be 5 per 10,000 exposures. Your estimated statistical risk would be less, as we don't know the HIV stats of your Ruskie hooker.

PEP (post-exposure prophylaxis) is recommended only for significant exposures to HIV. It is most effective when begun as soon as possible after exposure. If more than 72 hours have lapsed since exposure, PEP would no longer by effective and should not be used.

HIV-antibody tests taken prior to the three-month mark are not considered definitive; consequently, you should wait until the three-month mark for a conclusive test result. You can read much more about all these topics hookers, condoms, PEP, HIV testing, other "one night in Bangkok"-type experiences, etc. in the archives of this forum. Have a look.

Good luck. Be well.

Dr. Bob

clarification from medical school text books :)

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