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Urgent: PEP after rubbing with wound and sore
Aug 2, 2010

Dear Dr,

Thanks a lot for your efforts in helping us with our doubts and anxieties.

My case is the following: I went clubbing last Friday night and I have an intense blackout (I am not used to drink and I got really intoxicated, and I don't remember much of the night) and I do not remember much except I was with a woman I met waiting a cab, who supposedly (my memories are quite vague) touched and rubbed my penis for a while (she refused to do anything else) and we also got involved in deep kissing, including rubbing tongues and small bites and suck (sorry for too explicit details). Next day I found a small sore in my pennis (can't tell if it was there the day before, that could be due to masturbation or alike, not sure, as other times in the past happened).

I met her today and she told we had no sex (oral or any other type) and confirmed my few vague memories. I noticed she had a small wound in her finger (she told be she has burnt today) After meeting today, she appear to me quite strange person and declared herself as very sexually active (orgies and multiple sex partners from both sexes). When asked about HIV status, she told me that as she is active uses protection and takes monthly examinations and that she was clean. When I asked her to test again she said we did no sex and that it was extremely ridiculous (I kind of agree). She also left angry for other reasons not relevant to the case. I suspect she could be a sex worker or alike (btw, in this country Hong Kong they are extremely controlled and tested by government, and the HIV rates are very low).

I am still in 40 hours after this possible exposure, so I am considering going tomorrow for PEP here in Hong Kong. I am extremely anxious due to my lack of experience managing this kind of situations.

I want to make a worst case scenario and assume she was HIV +ve. My questions are: 1) It is worth going PEP, or the risk is still relatively low? This is important to take action now. 2) Does the fact of a wound in her finger and the sore in my penis increase the risk? 3) I don't know if we did anything else, I dont remember and she says no, but I don't trust here much. Is there any way to know whether we had anything more than just rubbing? 4) Deep kissing as I described is risky? 5) Is there any test that can detect my status before the 3 month window?

I know that my anxiety and drinking are a problem and I am working on them. I would really appreciate your help solving these questions.

Thanks,

Wilson

Response from Dr. Frascino

Hello Wilson,

1. Nope.

2. Nope.

3. Nope.

4. Nope.

5. Nope.

My advice is that you attend to both your anxiety and drinking problems. For peace of mind you can get a single HIV-antibody test at the three-month mark. From what you've explained the result will undoubtedly be negative.

Dr. Bob



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