Assessing HIV Infection Risks After Contact with a Sex Worker - Internal Medicine

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When assessing the risk of HIV infection after contact with a sex worker, it's essential to understand the modes of transmission and the specific circumstances of your encounter. Based on the details you provided, let's break down the three points of concern.

1. Handjob and Semen Contact: You mentioned that the sex worker provided a handjob using lubricant, and after ejaculation, she wiped off the semen with a tissue. The risk of HIV transmission through this scenario is very low. HIV is primarily transmitted through direct contact with infected bodily fluids, such as blood, semen, vaginal fluids, and breast milk. In this case, unless the sex worker had open wounds or sores on her hands, and unless those wounds were in direct contact with your mucous membranes (like the urethra), the risk of transmission is minimal. The act of wiping semen with a tissue further reduces any potential risk, as the virus does not survive long outside the human body.

2. Nipple Sucking: You also mentioned sucking on the sex worker's nipples. The risk of HIV transmission through oral contact with the breasts is extremely low, especially if you do not have any open sores or bleeding gums in your mouth. While HIV can be present in breast milk, the likelihood of transmission through this route is significantly lower compared to other forms of sexual activity. If you are confident that your mouth was intact and without wounds, this act alone would not pose a significant risk.

3. Touching the Underwear: Touching the sex worker's underwear without direct contact with her genital area further reduces your risk. HIV is not transmitted through casual contact, and unless there was direct exposure to infected fluids, the risk remains negligible.

Given these points, your overall risk of contracting HIV from this encounter appears to be very low. However, it is always prudent to be cautious and proactive about your sexual health. If you are still feeling anxious about potential exposure, it is advisable to get tested for HIV and other sexually transmitted infections (STIs).
Testing Recommendations: The general recommendation is to get tested for HIV at least 2-4 weeks after potential exposure, as this is when most tests can reliably detect the virus. However, for conclusive results, it is recommended to follow up with additional testing at three months post-exposure. If all tests return negative after this period, you can be more confident that you have not contracted HIV.

In summary, while your risk from the described activities is low, regular testing and open communication with sexual partners about health status are key components of responsible sexual health practices. If you have ongoing concerns or experience any symptoms, consulting a healthcare provider for further evaluation and guidance is always a good idea.