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Unprotected sex. Feeling suicide. Pls help!!! URGENT!!!
Jul 7, 2005

Dear Brian:

A week ago, I made a very bad mistake. I had unprotected vaginal intercourse for about 10 minutes with a Nigerian prostitute in Italy. Sex leads to ejaculation. I'm uncircumcised like many other Europeans. I didn't note any scratches or bleedings after intercourse and the girl's vagina wasn't very wet. We lubricated both with saliva. Maybe this will decrease the risk. I really hope it. My doctor said to me that the risks of a single unprotected heterosexual episode is very low and that he is more concerned about my psychological status than for the possibility of an infection. Is it really true that uncircumcised man risks more than a circumcised one? I heard about a study that explains the exact opposite: in uncircumcised men the intact foreskin produces an enzyme that kills bacteria and viruses and protects the penis from mucous membranes. It tells also that the inner lining of foreskin has a thin cornified layer that provides additional protection. What is the truth? I'm very scared, confused and depressed. I need help.

Response from Dr. Conway

First, I am pleased that you realize that you made a mistake. The key here is not to beat yourself up but to figure out how you will avoid making such mistakes in the future.

Uncircumcised men are clearly at more risk of becoming infected from sexual contact, probably due to increased contact time with genital secretions. This being said, the risk of HIV transmission from a woman to a man from a single contact is 0.1% or less, and this is if you knew for a fact she was HIV- infected. You will need to have HIV testing done over the next 3 months to estblish that you have not been infected, but the risk is truly very low. I would be more concerned about other sexual infections, such as gonorrhea, chlamydia, syphilis and herpes, and you should consider tests for those.

The key here, my friend, is probably your risk management strategy for the future....



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