Ask a doctor on the topic of Internal medicine

Risk of HIV infection?

January 13, 2014 | 30,00 EUR | answered by Dr. med. Frauke Gehring

Good day,

I urgently need advice!! I am going crazy and experiencing real panic attacks.

On Wednesday, 08.01.14, I visited a prostitute who was/ is available in a hotel...

I always make sure that intercourse always takes place with a condom. However, when I was having intercourse from behind, I noticed after about 10 minutes that the condom looked "weird" (had slipped up), I then pulled out my penis and saw that the condom was completely torn, meaning the glans was completely exposed, and I had approximately 10 minutes of unprotected sex with her before I noticed...

I immediately rushed to the bathroom and washed myself with soap, as well as with Listerine mouthwash because I thought it contained alcohol.

She then assured me she was healthy, told me not to worry, etc., but could not show me a test. What I still remember is that she comes from the Czech Republic.

I researched this woman on the internet at home because I couldn't stop thinking about it and shockingly discovered that she is known in several forums as an AO prostitute (offering her services without a condom) and allows her clients to have sex without a condom and without being tested.

That naturally put me in a panic!! I read some reports where many people wrote about having sex without a condom... What somewhat reassured me was that I couldn't find anything about any diseases in her past (gonorrhea or similar) or mention of any contagious diseases.

The next day, I made an appointment with my general practitioner and told her about it.

I also asked her about this HIV-PEP thing.

She said that this should only be done if there has been a risk contact with an HIV-positive person, as the side effects could be very severe, and the whole thing would have to be paid for privately (1000 - 1500 €).

I have been searching the internet for days now and am having more and more horror thoughts.

What also really upsets me is that I read that the risk of getting infected with HIV is much higher in uncircumcised men (I have phimosis).

On Saturday, I got slight headaches and severe sore throat (first signs ???). I really don't know what to do, I am totally desperate that I could have been infected with HIV or other sexually transmitted diseases.

This morning, Monday, I went back to my general practitioner because the sore throat just wouldn't go away and actually became more painful. She diagnosed tonsillitis with swollen lymph nodes. I also have a slight fever. She prescribed Penicillin V 1.5 Mega for me.

I am very worried that these are the first signs of an HIV infection. I am really desperate!!

My doctor said she will inquire in the laboratory if they can also perform a PCR test. I will do this 15 days after the risk contact. I can't take it anymore and want certainty.

How sure can I be that the result of the PCR test is 100% accurate and correct?

Does the penicillin (which I should take for 10 days) actually help with infections that I could have contracted – gonorrhea or whatever else there is?

Can a viral infection or cold affect the result of the PCR test?

How do you assess the situation, what is the risk (%) that I have been infected with HIV (especially because I am not circumcised, etc.)?

I regret everything so much and would like to turn back time. I think about it all day and just lie in my bed worrying. I have terrible nightmares :((

Thank you in advance!!

Best regards

Dr. med. Frauke Gehring

Good day,

The probability of HIV infection through unprotected vaginal intercourse with a woman of unknown HIV status (including sex workers) is approximately 1 in 10,000 or even lower. (Since the lady engages in high-risk sexual activities, the probability is closer to 1 in 10,000). Therefore, according to guidelines, there is no indication for post-exposure prophylaxis (PEP) and certainly no reason to panic.

Symptoms of a flu-like illness after HIV infection typically appear at the earliest 7 to 14 days later (as the viruses would need time to replicate). Therefore, you do not have early symptoms of HIV.

The PCR test is pointless as it does not provide reliable results at such an early stage. It detects the virus directly, and the earlier the test is conducted, the more likely it is to give a false negative result (as there would be fewer viruses in the blood). It is not suitable as a screening test and would not be covered by your health insurance. Due to its lack of reliability, I would advise against spending a large amount of money on it!

The only sensible test is the ELISA antibody test, which shows reliable results after 3 months since the antibodies develop at different rates. If you are extremely anxious, you could consider taking a test after 6 weeks, but if it is negative, it must be confirmed by a second test after 3 months.

Penicillin would not be sufficient to treat a gonorrhea infection. If there are signs of a sexually transmitted infection, it is advisable to consult a urologist.

In summary, there is no need to panic, but there is a certain (though really minimal!) risk, which makes an antibody test after 3 months advisable. Until then, you will need to be patient and should use a condom for any further sexual encounters as a precaution.

Wishing you all the best!

Warm regards, Dr. Höllering, Specialist in Internal and General Medicine, Sexual Medicine