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three protected vaginal and unprotected oral sex with csw in China

Question: 

Hi there,

I am a Canadian working in Beijing. On june 24, 2018, I ordered an outcall services, and the girl gave me an oral sex for a short while followed by protected vaginal sex (she sat on me). I think the condom did not break (my "stuff" was not leaking out, so I assume it was intact) but the condom used was not any international brand that I am familiar with.

On Agust 24 2018, I found a massage parlor and tried the service. First, it was just unprotected oral sex. And somehow I thought this girl was safe, and decide to do unprotected oral sex + protected vaginal (she sat on me) on August 29.

During September, I visited the massage parlor for another two times. On September 7th, I did unprotected oral sex only. On September 30, I did unprotected oral sex and protected vaginal sex (I inserted into her).

At first, I was not so worry about these encounters as I had used condom for all of the vaginal sexes, and I did not experience any symptom (no diarrhea lasting for more than a day, no rash, no fever, no sore throat etc;). Additionally, for all the vaginal sexes I couldn't get very hard and ejaculate after 20-30 seconds or even shorter. The outcall girl's boss told me that the girl is clean and the massage girl told me that she got check regularly.

Recently I read a news about the number of HIV paitent in China that has increased rapidly during the third quarter, which made me start to worry and led me to here. Now I am worrying about the condoms I used were not effective as they are some unknown chineses brand brand and somehow these encounters could accumulate (it sounds super stupid).

My current concerns are 1)the condom could be fake and it did not work though it covered my penis 2) the condom could have little hole that vaginal fluid can come through. Can you tell me what are the chance of getting hiv if my concerns were real.

I've already booked a body check this weekend, but start having imagination of getting a positive report back. I understand that you get questions like this a lot, and I apologise. I just want have some professional opinions regarding the chance of having negative report so that I can wait for my report more peacefully.

Thanks
A worry paranoid

Answer: 

Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about acquiring HIV through protected vaginal sex and unprotected oral sex. From the information given, these scenarios are determined to be Low Risk (Evidence of transmission occurs through these activities when certain conditions are met).

The scenario mentioned above does meet the three components of the transmission equation. In order for the transmission equation to be satisfied there must be bodily fluid, a high risk activity and direct access to the bloodstream. In the given scenario bodily fluid could be passed through vaginal sex in the case of the condom breaking or improper use and direct access to the bloodstream via the penis (1). The scenario of unprotected oral sex would include bodily fluid, a lower risk activity, and direct access to the bloodstream (1). If you engage in higher risk activity it is recommended to look into biomedical approaches such as PrEP and PEP that help to decrease your risk of acquiring HIV (2). Refer to your physicians for further information.

Recommendation: Refer to Physician for HIV test.

Regards,

AIDS Vancouver Helpline/Online, Danielle