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A fresh torn wound on Penis during vaginal intercourse

Question: 

 
Hi, I have involved myself in severe exposure of HIV risk and other STDs. Last week I went to a brothel in Dongguan China. The girl first started to wash me up with her breast, butt and her tongue by rugging against all over my body (including my Penis) and she dry me up with a towel. Then she started to masturbate my penis with her dry hand, and with couple instances she masturbate my penis too hard and I felt quite sting. I ask her to stop, and she started to use her tongue to lick my balls and the then the shaft of the penis. After that I put on a condom and we had vaginal intercouse. After I ejeculate inside her vagina, I did continue to have my penis in motion (back and forward) for about 10 to 12 times. Then when I want to withdraw, I cannot see the ring of the condom and then the girl moved away. I am not sure whether the condom was slip away or broken. I asked the girl and she said after I withdrew, the condom was still attached in her vagina with the condom.ring hanging out of her vagina.

After the intercourse I found out there was a fresh torn wound with some blood on my penis and the size of the wound is about 1cm wide. It is located about 1.5 to 2 inches from the tip of the penis head. This wound was torn early on when the girl did the hand masturbation on my penis.
What is my risk for HIV infection?
I will take the 4th generation HIV test with P24 antigen next week (21 days after exposure). How accurate with this test after 21 days after exposure?
I am extremely regretted with my action and I am massively worried. Please help

 

Answer: 

Hello there and thank you for using the AIDS Vancouver Helpline as your source of HIV/AIDS related information.
Before addressing your concerns, I would like to note that having any sexual activities with a commercial sex worker does not put you at any higher risk of acquiring HIV than anyone else. HIV does not discriminate based on characteristics of an individual (age, gender, sexual orientation, ethnicity, where they live, occupation, etc). It is the activity (unprotected anal/vaginal sex, sharing needles) that poses a significant possibility of HIV transmission.
It is theoretically possible to acquire HIV through open cuts and sores, but there has never been a reported case of HIV infection in this way (the only one was a bloody fight with a knife). You have to have an actively bleeding deep open cut to even pose a risk to begin with. Having a fresh torn wound on your penis does not necessary meant that there is a direct access to the bloodstream.
Because you are not sure whether the condoms did actually slipped off or broke, it is best for you to be tested as you are considering.
4th generation EIA test looks for both antigens (P24) and antibodies. P24 is detectable immediately after infection and only for the first few weeks and antibody portion of the test can detect up to 95% of infections within 4-6 weeks. Thus a test result at 21 days after possible exposure will give you a great indicator of your status. It is still advised to retest at/after 3 months (12 weeks) to receive a conclusive result. If you have not engaged in any high risk activities (unprotected vaginal/anal sex, sharing needles) during this period, the result will likely be same.
There are more than 30 sexually transmitted infections (STIs). Unlike HIV, some STIs, such as syphilis Chlamydia and gonorrhea, are very common and easier to transmit. So I suggest you to be tested for all STIs as well as HIV.Here at AIDS Vancouver, we do encourage all sexually active individuals to be tested for all STIs, including HIV, regularly to know your status and protect yourself and your partner(s). It may be every 3-4 months, bi-annually or annually, depending on an individual.
Hopefully your question is answered.If you have any other questions/concerns, please feel free to write us back.
Stay healthy and keep smiling,YoshikoAIDS Vancouver Helpline VolunteerE-mail: helpline@aidsvancouver.orgPhone (Mon-Fri 9am-4pm): (604) 696-4666Web: www.aidsvancouver.org/helpline

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