Anonymous
Hi. last year I contracted herpes at the base of the shaft of the penis where it is not covered by condom(lower bladder area).
I abstain from sex when outbreaks happen and I always use condom.
how ever last month I had a protected sex with a female sex worker, I noticed that her vaginal fluid come to contact with the location where my herpes outbreaks always happen(no active lesion at that time).
I read online that having herpes increases risk of hiv transmission even if the active lesions are not present.
I wanted to know my risk from the above mentioned event.

thanks
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Anonymous
Hello,

Thank you for your inquiry. From what we gather from the question, you were asking about the risk of acquiring HIV after having protected intercourse with a community sex worker. From the information given, this scenario is determined to be Low Risk (Evidence of transmission occurs through these activities when certain conditions are met).

The scenario mentioned above could meet the three components of the [Transmission Equation](https://www.aidswindsor.org/healthy-me/hiv-transmission/) if the condom was not used properly and/or broke during intercourse. Laboratory studies have shown that as long as the condom is made from latex, nitrile, polyurethane, or polyisoprene the risk of HIV transmission is very low (1). Moreover, condoms are not 100% effective at preventing HIV transmission, and thus testing is recommended after engaging in such activities.

That being said, the fact that you have the Herpes virus may also increase your risk of acquiring HIV in this case. Although it was previously believed that having active lesions is what causes the ideal environment that increases the risk of transmitting the virus, recent studies show that even treated HSV-2 infections provide a cellular environment conducive to HIV infection (2).

That being said, your one saving grace is that the vaginal fluid came in contact with the base of the shaft of your penis, where there is no ability to enter the body.

Recommendation: Refer to a health care provider for HIV testing, due to the Low Risk exposure described above.

Regards, AIDS Vancouver Helpline/Online, Samantha
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