
What Are Chances Of HIV Inspite Of Having Unprotected Oral Sex?

I received unprotected oral sex and we also engaged in protected penetrative sex (using condom) And only for 5 minutes. Obviously I don't know whether this woman has HIV but I'm scared since she is a sex worker. What's worse is that I have a minuscule cut/nick on the base of my penis from shaving 2 hours previous to the episode which I'm not sure if the condom covered. One on my penis can barely even be classed as a cut, think i just nipped the skin and made a red mark as I dont remember any blood and it doesn't even appear to have any 'scab-like' appearance....however there is a small cut that is located on my scrotom, very close (basically beside) the base of my penis which obviously wouldn't have been inside the vagina but may have touched it, I'm not entirely sure, would this count as risk?
Also because these cuts are small like I said, would 2 hours provide enough time for them to 'heal' enough to form a barrier against infection if I was exposed? As I said i have no recollection of any bleeding etc but they are still present which is a worry.
Also today (the next day) I've awoken to feeling lethargic and I have a sore throat...could these be early symptoms?
Basically I'm finding every reason to panic.
What is my likelihood of hiv transmission? Again this is hypothetical because the lady may not have HIV but being a sex worker the worry is always there. The lady clearly stated she never had penetrative sex without using 'protection'. Furthermore, I know you can't really tell if someone has HIV by appearance but from what I remember she seemed well, e.g. no obvious symptoms such as fever or rash.
Also I'm within 24 hours, is there enough of a case for me to get PEP or am I just being overly paranoid? I heard PEP can have pretty dire side affects.
Basically after this dreadful episode, I'd like reassurance as to whether I'm panicking over nothing or whether I have genuine concerns over a 'high risk exposure'
PEP recommended as a one time medication & relax
Detailed Answer:
Hi there XXXXXXX
I have read through your detailed description of the act & events surrounding & viewed the attachments.
I have to say that your chances of acquiring an infection are extremely slim given that the penetrative part of the action was protected.
However, playing the devil's advocate, I would advocate for a PEP perhaps as a one time single cocktail mix that your local GP or pharmacist would be happy to provide & ONLY because the person concerned was a commercial sex worker.
Then, put the incident behind you & move on.
I do think you are panicking & that is natural & an expected reaction in hindsight.
As for the side effect of PEP, as a single one time course, I don't envisage a problem. In fact the benefits to your mind that you are doing something 'concrete' as opposed to speculation are far more advantageous than the side effects! Besides, you will have to wait for a minimum of 1-2 weeks otherwise to get some sort of an accurate assessment via a PCR test & believe me the wait is not worth it.
I would say 99.9% you are clear & the risk is less than 0.1% given your particular scenario. It is your call in the end but I do believe you are on a safe wicket given that there was no admixture of blood & blood products & can stop speculation & carry on with your life.
Trust I have given you a clear action plan & put your mind to rest.
Good Luck & Godspeed!
Dr Praveen Rodrigues MD

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