Anonymous
I had a tiny needle puncture wound at the base of my penis in the morning which I wiped with alcohol swabs and forgot about and couldn't even see then. The same night I had protected sex with a few times with a woman in the vagina and also in her anus. I then realized that she was bleeding from her vagina and could see blood on the condom. That's when I removed the condom and washed my penis and started checking the base of my penis for the puncture wound from the morning. I couldn't find the puncture wound because it wasn't bleeding anymore but am worried about her blood coming into contact with this puncture wound at the base of my penis which could be outside the area covered by the condom. Now assuming she is HIV possitive, what are my chances of contracting HIV. Please reply quickly because it's been over 24 hours now and my window for Post Exposure Prophylaxis is closing.
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Anonymous
Hi there, thank you for contacting the AIDS Vancouver Helpline for HIV and AIDS related information.

First of all good for you for using a condom, this is the best way to protect yourself from sexually transmitted infections (STIs) including HIV.

To answer your question, the fact that you had puncture wounds at the base of your penis does not affect your risk for HIV transmission whatsoever. Small cuts or wounds begin to heal immediately after they occur and the body creates barriers that prevent viruses from entering the blood stream. Your puncture wounds would not provide access to your blood stream for the virus. Your exposure, which is simply protected sex, would be considered low risk for HIV transmission, regardless if she was bleeding or not. There is a small level or risk associated with protected sex as occasionally the condom is not used properly: If the condom is not put on properly, it breaks, it is expired, or if the penis is not removed while still erect, it may be possible that some sexual fluids are exchanged increasing risk for transmission.

Keep in mind that the HIV virus is very difficult to transmit. In fact, only 5 in 10 000 exposures by unprotected insertive penile-vaginal intercourse, result in transmission. THe risk is far lower for protected sex, it is very unlikely that you were exposed to the virus.

Regarding post exposure prophylaxis (PEP), in Canada you would not be considered for PEP as your exposure was not definitive nor was it high risk. With respect to the window period for PEP, PEP is only considered within the first 72 hours after exposure. This treatment however would unlikely be appropriate for you.

Regarding testing, we do recommend that everybody who is sexually active be tested for all sexually transmitted infections (STI's), including HIV, as part of continued health care maintenance and prevention.

I hope I have answered your questions and alleviated some of your anxiety. If you have any further questions please feel free to contact us again or visit [www.avert.org](www.avert.org) for additional reliable HIV related information.

In health,

Arne, AIDS Vancouver Helpline Volunteer
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