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Can HIV Be Contracted Through Unprotected Sexual Intercourse?
Question: I didn't actually see a doctor per se but I did go into a lab this morning to drop off a blood sample. They are going to do a PCR test. I should find out the answer by friday/saturday. However, I wanted to talk to one of you guys so that maybe it will calm my nerves.
Early July: I had unprotected sex with an asian escort. She happened to be a little older. She appeared to be in her 40's. She may have just arrived in the states. I asked if she had condoms, and she apologized and sort of said that she either ran out or didn't have any to begin with. Long story short, I had unprotected sex with her. From what I understand, the probability of contracting HIV from this encounter is about 1/2000. But then again, I have heard stories of an individual contracting HIV from just one single sexual encounter.
On a scale of 1-10, how worried should i be?
I can't even focus at work because I'm so worried.
Early July: I had unprotected sex with an asian escort. She happened to be a little older. She appeared to be in her 40's. She may have just arrived in the states. I asked if she had condoms, and she apologized and sort of said that she either ran out or didn't have any to begin with. Long story short, I had unprotected sex with her. From what I understand, the probability of contracting HIV from this encounter is about 1/2000. But then again, I have heard stories of an individual contracting HIV from just one single sexual encounter.
On a scale of 1-10, how worried should i be?
I can't even focus at work because I'm so worried.
Brief Answer:
I hope your PCR test turns out negative
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. There is an slight chance of you getting infected with HIV following the incident.
2. The risk is about 1 in 2000 to 4000 cases per act of unprotected sexual intercourse which is 0.05 percent.
3. For peace of mind please get rapid 4th generation HIV combo test for HIV 1 and 2 antibodies and p24 antigen done. This is highly accurate at 1 month from probable sexual exposure.
4. The PCR test has been rarely seen to give false positive result and not a standard screening test for HIV, though it might be useful to show virus particles in those infected.
5. The p24 antigen test is more accurate and internationally recommended and conclusive at 1 month for HIV 1 infection.
6. Since the escort was asian, it is recommended you to get tested at 6 months for HIV 2 antibodies.
7. There is no need to worry and get distressed because the sexual act happened a month back and worrying will not allow you to focus at work. On a scale of 1 to 10, the worry factor might be 3 or 4 for you. I hope your PCR test turns out negative.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
I hope your PCR test turns out negative
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. There is an slight chance of you getting infected with HIV following the incident.
2. The risk is about 1 in 2000 to 4000 cases per act of unprotected sexual intercourse which is 0.05 percent.
3. For peace of mind please get rapid 4th generation HIV combo test for HIV 1 and 2 antibodies and p24 antigen done. This is highly accurate at 1 month from probable sexual exposure.
4. The PCR test has been rarely seen to give false positive result and not a standard screening test for HIV, though it might be useful to show virus particles in those infected.
5. The p24 antigen test is more accurate and internationally recommended and conclusive at 1 month for HIV 1 infection.
6. Since the escort was asian, it is recommended you to get tested at 6 months for HIV 2 antibodies.
7. There is no need to worry and get distressed because the sexual act happened a month back and worrying will not allow you to focus at work. On a scale of 1 to 10, the worry factor might be 3 or 4 for you. I hope your PCR test turns out negative.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. XXXXXXX
Thank you for answering my question. I do have some follow up questions/comments:
Most of the sex that I had with her was oral. I did however, insert my penis into her anal cavity about 3 times until she complained. Next, I inserted my penis into her vagina in and out twice. The remainder of the sexual act was oral.
1. I have seen the 1/2000 to 1/4000 statistic before. Can you please explain to me what that actually means? Does it basically mean that if 2000-4000 men each had sex with an HIV positive female, that only 1 of us would be infected?
2. If the picture I described in #1 is accurate, I do feel much much better about my chances and will feel like I can relax and breathe.
3. What is special about asian escorts that I would nee to get tested again at 6 months?
4. If I do indeed have a 1/2000 to 1/4000 chance of being infected, why is my worry factor at 3 or 4? I do understand, it is a subjective figure but I woul peg myself at a 2 or 3, personally.
Lastly, I know none of this really matters at this point. I just have to wait and see. If my test shows up negative, I'm swearing my self off paid sex forever and volunteer for the next aids walk.
Thanks,
XXXXXXX
Thank you for answering my question. I do have some follow up questions/comments:
Most of the sex that I had with her was oral. I did however, insert my penis into her anal cavity about 3 times until she complained. Next, I inserted my penis into her vagina in and out twice. The remainder of the sexual act was oral.
1. I have seen the 1/2000 to 1/4000 statistic before. Can you please explain to me what that actually means? Does it basically mean that if 2000-4000 men each had sex with an HIV positive female, that only 1 of us would be infected?
2. If the picture I described in #1 is accurate, I do feel much much better about my chances and will feel like I can relax and breathe.
3. What is special about asian escorts that I would nee to get tested again at 6 months?
4. If I do indeed have a 1/2000 to 1/4000 chance of being infected, why is my worry factor at 3 or 4? I do understand, it is a subjective figure but I woul peg myself at a 2 or 3, personally.
Lastly, I know none of this really matters at this point. I just have to wait and see. If my test shows up negative, I'm swearing my self off paid sex forever and volunteer for the next aids walk.
Thanks,
XXXXXXX
Brief Answer:
The risk is 1 in 2000 per unprotected sexual act with unknown HIV condition
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. The 1 in 2000 to 1 in 4000 is the chance of getting HIV per act of unprotected sexual intercourse.
It means that if there are 2000 sexual events involving random people (HIV positive, negative or HIV report unknown) which have taken place then 1 of the male participants might proceed to get infected with HIV.
If you consider that "2000-4000 men each had sex with an HIV positive female" then many more people will end up with HIV infection.
2. The picture in 1. refers to unprotected sexual intercourse between males and females of unknown HIV condition. However the picture is still better than what most people think. I guess escorts are regularly tested for HIV infection in your area.
3. HIV infection might occur from HIV 1 or HIV 2 type viruses. The HIV 1 virus is found in every part of the world and HIV 2 virus in found in about 2 percent of cases in asia. Therefore if the escort was asian then there is a remote possibility of HIV 2 infection and the test for this is conclusive only at 6 months through HIV 2 antibody test. HIV 1 virus contains p24 antigen and the test is conclusive after 1 month.
4. I was not aware of the number of sexual events taking place in your case and therefore put s slightly higher number. It is clear that you have had vaginal and anal sex. Therefore there is a slight increase in chance to about 1 in 1000 to 1 in 1500. Please remember that this is subjective interpretation and 2 or 3 is also acceptable. I have come across patients who have anxiety of 8 or 9 at times and that should not happen.
5. I guess you have taken a big risk and once you are aware of HIV and the risks involved then you will keep yourself safe.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
The risk is 1 in 2000 per unprotected sexual act with unknown HIV condition
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. The 1 in 2000 to 1 in 4000 is the chance of getting HIV per act of unprotected sexual intercourse.
It means that if there are 2000 sexual events involving random people (HIV positive, negative or HIV report unknown) which have taken place then 1 of the male participants might proceed to get infected with HIV.
If you consider that "2000-4000 men each had sex with an HIV positive female" then many more people will end up with HIV infection.
2. The picture in 1. refers to unprotected sexual intercourse between males and females of unknown HIV condition. However the picture is still better than what most people think. I guess escorts are regularly tested for HIV infection in your area.
3. HIV infection might occur from HIV 1 or HIV 2 type viruses. The HIV 1 virus is found in every part of the world and HIV 2 virus in found in about 2 percent of cases in asia. Therefore if the escort was asian then there is a remote possibility of HIV 2 infection and the test for this is conclusive only at 6 months through HIV 2 antibody test. HIV 1 virus contains p24 antigen and the test is conclusive after 1 month.
4. I was not aware of the number of sexual events taking place in your case and therefore put s slightly higher number. It is clear that you have had vaginal and anal sex. Therefore there is a slight increase in chance to about 1 in 1000 to 1 in 1500. Please remember that this is subjective interpretation and 2 or 3 is also acceptable. I have come across patients who have anxiety of 8 or 9 at times and that should not happen.
5. I guess you have taken a big risk and once you are aware of HIV and the risks involved then you will keep yourself safe.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for taking the time to answer my questions.
I have one very last one.
Let's just say, hypothetically, that the asian escort does have HIV. Are there any statistics that will tell me what the chances are then?
In a reply from an individual in a similar circumstance to mine: Dr. H Hunter Handsfield wrote in the following link: http://www.medhelp.org/posts/HIV---Prevention/Worried-sick-about-sex-with-escort/show/0000
"4) Even if there was unprotected vaginal sex, and if your escort partner had HIV, the average chance of transmission is once for every 2,000 exposures. (That's why many spouses of HIV infected people remain infection free themselves for years on end.) (Going back to question 3: if someone wanted to give someone HIV, why would s/he use a method that has only 1 chance in 2,000 of being successful?)"
He basically posited that the chance of transmission if the escort had HIV is 1/2000. I would think that if the HIV status of the escort is known then the statistic would be much much less favorable.
Do you have any thoughts on this Dr.'s opinion?
I have one very last one.
Let's just say, hypothetically, that the asian escort does have HIV. Are there any statistics that will tell me what the chances are then?
In a reply from an individual in a similar circumstance to mine: Dr. H Hunter Handsfield wrote in the following link: http://www.medhelp.org/posts/HIV---Prevention/Worried-sick-about-sex-with-escort/show/0000
"4) Even if there was unprotected vaginal sex, and if your escort partner had HIV, the average chance of transmission is once for every 2,000 exposures. (That's why many spouses of HIV infected people remain infection free themselves for years on end.) (Going back to question 3: if someone wanted to give someone HIV, why would s/he use a method that has only 1 chance in 2,000 of being successful?)"
He basically posited that the chance of transmission if the escort had HIV is 1/2000. I would think that if the HIV status of the escort is known then the statistic would be much much less favorable.
Do you have any thoughts on this Dr.'s opinion?
Brief Answer:
I partly agree to the views of Dr.Hunter but opinions cannot be generalized
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. If the asian escort has HIV then the chances are one count of insertive penile vaginal intercourse (risk 4 in 10000) plus one count of insertive anal intercourse (risk 11 in 10000). Therefore the total risk you have is 14 in 10000. This is equal to 1 in 714 and is 0.14 percent.
2. The above figure is calculated from the latest statistics provided by CDC XXXXXXX which is a reputed organization in the world.
Please click he link below for complete details
http://www.cdc.gov/hiv/policies/law/risk.html
3. I partly agree to Dr.Hunter in his views but you know in todays world it is difficult to know which escort will self declare that she is HIV positive and still proceed entertaining and providing sexual services. Therefore sex with any person other than your faithful partner is questionable.
I have clearly mentioned in my earlier reply that the statistics are for acts of sexual intercourse with people of unknown HIV status. This includes people who are HIV and those who might possibly test positive should they get tested. We know that HIV might be transmitted by a person even before he or she knows that they are infected. Therefore such sources have to be accounted for and on a broad range, considering the highest chances of HIV transmission; I feel 1 in 2000 is a reliable number. However, now I put your risk at 1 in 714 as the highest risk.
4. Some of the statistics is purely hypothetical. No one would really try having sex with 2000 different partners or have sex on 2000 occasions with a confirmed HIV positive partner and then try to match statistics.
5. Every human is different and the attack rate varies with every individual. HIV has a low infectivity rate and this depends on many factors like the viral load in the host, the ability of the HIV to enter the recipient, the chances favouring exchange of body fluids among others. Therefore, after giving deep thought, I would calculate your risk of getting HIV as 1 in 714 in the worst situation. In the end, we have to remember that we are only discussing numbers and hope that you are lucky and your report comes negative.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
I partly agree to the views of Dr.Hunter but opinions cannot be generalized
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. If the asian escort has HIV then the chances are one count of insertive penile vaginal intercourse (risk 4 in 10000) plus one count of insertive anal intercourse (risk 11 in 10000). Therefore the total risk you have is 14 in 10000. This is equal to 1 in 714 and is 0.14 percent.
2. The above figure is calculated from the latest statistics provided by CDC XXXXXXX which is a reputed organization in the world.
Please click he link below for complete details
http://www.cdc.gov/hiv/policies/law/risk.html
3. I partly agree to Dr.Hunter in his views but you know in todays world it is difficult to know which escort will self declare that she is HIV positive and still proceed entertaining and providing sexual services. Therefore sex with any person other than your faithful partner is questionable.
I have clearly mentioned in my earlier reply that the statistics are for acts of sexual intercourse with people of unknown HIV status. This includes people who are HIV and those who might possibly test positive should they get tested. We know that HIV might be transmitted by a person even before he or she knows that they are infected. Therefore such sources have to be accounted for and on a broad range, considering the highest chances of HIV transmission; I feel 1 in 2000 is a reliable number. However, now I put your risk at 1 in 714 as the highest risk.
4. Some of the statistics is purely hypothetical. No one would really try having sex with 2000 different partners or have sex on 2000 occasions with a confirmed HIV positive partner and then try to match statistics.
5. Every human is different and the attack rate varies with every individual. HIV has a low infectivity rate and this depends on many factors like the viral load in the host, the ability of the HIV to enter the recipient, the chances favouring exchange of body fluids among others. Therefore, after giving deep thought, I would calculate your risk of getting HIV as 1 in 714 in the worst situation. In the end, we have to remember that we are only discussing numbers and hope that you are lucky and your report comes negative.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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