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Unprotected sex with an Ethiopian prostitute
Mar 26, 2011

I bet a lot of questions here start with the same statement" I am so F***ing stupid" well I am, and I made a big mistake. I was heavily under the influence of alcohol and brought home a prostitute from Ethiopia. We started with a condom but after an hour of protected sex I could not ejaculate and in my drunk state I pulled the condom off and we had about 20 minutes of unprotected vaginal and oral sex. When I woke up in the morning I was still drunk but I realized I mate a possible fatal error. I went into the Emergency Department and lied about the incident. I am currently in the middle east and could go to jail if I told the truth. I work in healthcare so I said I had a dirty needle stick from someone with HIV. They issues me PEP but they have never issued it before and where not very familiar with it. I took my first dose 23 hours after the exposure and I am not on my seconday of it. I am very tired and have some nausea. I may not be able to get the sex worker tested for HIV because of my location, but if I manage to and she comes up with a negative test would you recommended I stop taking the PEP? I read up on PEP and it seems very dangerous to take. What are my chances of getting HIV based on my story? I am 28 and have never been with a prostitute before or done anything like this. I am so freaking scared right now and can't believe what I did. I don't want to die from aids but I also do not want to die from taking pep

Response from Dr. Frascino

Hi,

Yep, I tend to get loads and loads of questions that begin "I am so F***ing stupid." So you have lots and lots of company here. Yes, you made a mistake, but don't be too hard on yourself. As I've mentioned before, the higher powers gave men both a brain and a tallywhacker, but only enough blood to run one at a time.

To answer your specific question, if you do test your Ethiopian hooker and she tests HIV negative, your HIV-acquisition risk would be limited to the rather remote possibility that she was only recently HIV infected and is still within her "window period" (HIV infected, but not yet producing detectable levels of anti-HIV antibodies). In that case, stopping PEP certainly seems reasonable. I'm a bit concerned the emergency department you visited was not familiar with PEP and had never prescribed it! YIKES! I encourage anyone who has had an HIV exposure significant enough to warrant a course of PEP be followed by an HIV specialist physician. Since you work in the healthcare field, hopefully you'll be able to arrange for this if PEP is continued for the full 28-day course. An HIV specialist would also be a good resource to help you decide if PEP should be discontinued.

Finally, I still find it appalling that there are countries where someone can be sent to jail for merely telling the truth about a sexually transmitted disease. No wonder there are mass uprisings throughout that part of the world! Let's hope a new era of enlightenment, common sense and compassion is dawning in the Middle East.

Good luck.

Dr. Bob



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