Dr. Jyotisterna Mittal
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I feel so stupid. I got drunk and ended up having sex with a CSW (Community Sex Worker). She gave me oral sex, and then we had vaginal sex. I did not touch her vagina with my fingers. Earlier in the evening, I had trimmed myself in my pubic area and had a slight abrasion, but there was no bleeding. I used a condom with her, and she even checked to see if it was intact. It was. Immediately after sex, she wiped me down toward the tip of my penis. I then went to the bathroom and urinated. Now, I am scared that I caught something. All this happened about 90 minutes ago. What are my chances of having caught a disease or HIV(Human Immunodeficiency Virus)? Should I see a doctor for a short course of antiretrovirals as prophylaxis? I am very worried. What should I do?
Hi, Welcome to icliniq.com.
I understand your concern. With protected sex, you are safe from contracting HIV (human immunodeficiency virus).
Patient's Query
Hi doctor,
Thank you for the reply.
Please be a little more detailed. But, I read several articles which give different percentages of protection for condoms ranging from 85 % to 100 %. So, should I still be worried? And, should I ask for an antiretroviral medication for prophylaxis, such as Truvada? How many days would you take it?
Hello, Welcome back to icliniq.com
The exact percentage of effectiveness of condoms is not known and is still being researched. But, when properly used, they are considered impermeable by the virus, and the risk of HIV is considered negligible to nil. I do not find any need to worry or start PEP (post-exposure prophylaxis). However, if you want to take Truvada (Emtricitabine), it should be started as early as possible after exposure and continued for 28 days without skipping any dose. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent.
Patient's Query
Hi doctor,
Thank you for the reply.
Since I am at very low risk, do you think I can simply take four to five days of Tenofovir (Viread) instead? It is a drug for hepatitis but is also sometimes used for HIV prophylaxis. My friend had some extra pills (he has hepatitis), and I just took one for prophylaxis. Or do you think this is going overboard? Should I stop worrying?
Hello, Welcome to icliniq.com.
There would be no use of four to five tablets of Tenofovir for HIV. No doctor would recommend ART (antiretroviral therapy) for this exposure according to guidelines. However, if you want to take it because of extreme anxiety, you should take a total dose of Truvada for 28 days. I would advise you to stop reading about your exposure or symptoms on internet resources as it would only lead to unnecessary stress and misinformation.
Good luck.
Patient's Query
Hi doctor,
Thank you for the reply.
Yes, the condom did not break. But, I am worried because she is a CSW and came to my country only two years ago from a place that is rampant with HIV. I am sure she was a CSW there too. And yes, I read up and found out that condom use is as protective as low as 80 % of the time. If you say that in my situation, no doctor would prescribe ART, then I will believe you (or try my best). So, bottom line, are you saying I do not need to do anything further? Can I go on with my life?
Hello, Welcome to icliniq.com.
The lower effectiveness of condoms may be for other STDs (sexually transmitted diseases) like molluscum or warts, but they are highly effective in preventing HIV. So, I find no reason to start ART (Anti-retroviral Therapy) after protected sex, even with a high-risk individual.
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Dermatology
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