Hello doctor,While having sex with a commercial sex worker (CSW) the condom broke. It was not more than 10 seconds before I found out, no ejaculation happened and I had no open sores on my penis or any other cuts, yet still I found a tiny amount of blood on the condom, I cannot think of any reason for the blood except that it could have been her menstrual blood (just the beginning of it). I am of a good general health, smoker and have never been diagnosed with any STD or any serious disease. I have asked her if this was the first time for her to have a condom failure incident and she answered yes, she even had a general blood test for a full checkup and she was in good health as well as the HIV blood test two years ago. My questions are as follows:1. I have read somewhere on the internet that the risk of transmission from a single encounter of unprotected vaginal sex is 0.065 %, meaning that 99.935 % do not get HIV, is that true?2. Do you recommend I get tested for HIV? I am thinking of getting a PCR test to check myself, how long should I wait before getting tested (PCR) and how accurate and reliable is that test?3. Do you recommend that I go for the PCR test or should I go for the fourth generation test and how long should I wait as well before the result is conclusive?4. Does being circumcised have anything to do with minimizing the risk of HIV infection?5. Does the presence of menstrual blood increase the risk of HIV infection?
Hi. Yes, the chances of HIV transmission by single unprotected intercourse is much less than 1 % (1/200 to 1/1000). The chances of HIV transmission is slightly higher during menstruation. Condom broken is almost similar to unprotected intercourse. The chances of HIV in the lady is almost nil with her tests showing negative results (attachment removed to protect patient identity). You can go for HIV1 and 2 RNA PCR after 10 days of exposure. It is more than 99 % sensitive after 10 days of exposure. You can go for this test to allay your anxiety.