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They don' add up - What's wrong?
Jul 19, 2011

Dear Bob,

You are a gift to the world, your words the greatest comfort for average people like me who have no idea what HIV is like and hence, perhaps the irrational fear.

And yes, I am plagued by this irrational fear, I really hope. Here goes, 2 weeks ago, I had protected oral sex and protected fingering with a sex worker. Now I am developing itchy skin on my head and upper part of my body. I try not to relate to HIV but I cannot stop thinking about it.

My incident goes like this, I have foot warts on the soles of my skin and I shared a shower with the lady. I noticed her cleaning her vagina and also had a small bandage on her finger. We shared the same shower head, I'm just thinking if some blood or her vaginal fluids were somehow passed to the areas which I touched, or via the floor cause I have warts (potential broken skin), what is my risk? By the way, I have small broken skin on my fingers as my skin tends to peel near the nails, I know cos I feel a small sting when it touches water.

Second, I had protected oral sex, I know its low risk, but still I have to tell you. And lastly, I fingered her vagina with a condom on, but the problem is about the broken skin I have on my fingers. If, somehow I got into contact with her vaginal fluids, what is my risk? Also, she touched her vagina briefly before handling the condoms, if some vaginal fluids got into the inside of the condom, which my fingers and penis were exposed to, what is the risk given I have broken skin, not bleeding but possibly fresh.

A final note, I took the lady for HIV screening the following day. We both tested negative, it should be reassuring, however, it added to my anxiety as HIV screening does not detect anything in the window period. If the lady was possible infected recently, and hence undetectable by HIV screening, she would have high loads of viral activity and given my exposure, my risk seems to be much higher than usual. I sincerely appreciate your honest opinion as I considered PEP but am way beyond the time frame for PEP to be effective.

Of course, the itchy skin and her possible being newly infected and hence high viral load are giving me plenty of worries, whether paranoia or rational.

Please kindly advise my risk and if I should get tested again.

Love, Asia.

Response from Dr. Frascino

Hello, Asia.

Your HIV-acquisition risk from the activities you describe are nonexistent. PEP certainly was not warranted.

If my reassurance is not sufficient for you to put your irrational fears permanently to reset, get a single HIV-antibody test at the three-month mark. The results will undoubtedly be negative.

Relax Max. All is well, including you.

Dr. Bob



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