Hiv Test

[anonaccount]

Hi,

I made some poor decisions earlier this week, ending up with me having sex with a bar girl. I initially used a condom but when I was done the bar girl had the condom in her hand. I'm not sure how she got it...my memory that night is quite hazy. Regardless, I am now a possible risk for having STDs including HiV.

The thought of HIV is absolutely terrifying, and I am having a hard time going about my daily routine. I read up and understand that the most general testing for HIV is done 3-6 months post exposure. I've also found information of other tests that can give accurate results with a much shorter "window period". Specifically the DNA/PCR HIV test.

My question<finally> do hospitals in Bangkok have HIV tests that I can take within 1-2 weeks post exposure that give deffinitive results? I am willing to pay a premium for an expedient peace of mind<hopefully>. I think waiting 6-12 more weeks would kill me.

Many thanks

[Prakanong]

First of all calm down - easier said than done but please try and think rationally.

Its highly unlikely you caught it from a one off straight un-protected sexual encounter like you just had. It is possible - I have a friend who caught it from his first week having unprotected sex with a girl of long standing.

Try and go for a test of the type you describe right now if you like but you will still need to go after 3-6 months if you want to be sure.

I had mine at Bumrungrad then Raffles in Singapore - the normal one 3 months apart

[ProThaiExpat]

If you do not have open pathways to your blood supply, ie. open lesions that would have come into contact with the Thai girls fluids, you are at very slight risk. If you are circumcised, you are even at less risk.

if you washed up right after exposure, your even at less risk. Since it is more than 24 hours since your exposure, immediate treatment is not possible.

Since your head is already into a test now not being completely convincing, you might as well wait until whatever information you believe in regarding the reliability of the HIV test time period has elapsed before testing.

[John_Rambo]

You're going to have to wait the three months to get the all clear. If the lady had the condom in her hand afterwards, it's possible it came off in her as you withdrew. I know it's easier said than done, but don't over-react and work yourself up into a state about this because the chances are extremely high at this stage that there is nothing wrong with you at all. In all likelihood, the test at three months is just going to be to give you the all clear.

[JimsKnight]

The slipped condom / split condom can be a nightmare situation, some of the 'fun' girls may have a grudge and may try and take the 'armour' off deliberatly without you knowing!

Another problem is that Thai condoms are of poor quality compared to British ones, Thai ones are more likely to slip.

This aside its 3 months for waiting out any possible HIV virus. Although I have heard of this '1 week after' test from bumungrad.

Some say 6 months to wait but this was before improved testing came along.

For future reference if you get 'exposured' through unprotected sex...

Clean your 'gonk' thoroughly in the shower as soon as your finished with your girl.

If you are uncircumcised you can 'cheat' circumcision by exposing your foreskin and putting up with a few days discomfort. This will make infection and absorbtion less likely.

Take some antibiotics (doxycyclin) for a few days, walk tall, stand proud and wait out the 3 month storm.

If its any consolation I had my 'armour' slip back in January and have just had the 'All Clear' having waited 4 months (to test for the pox as well). During this time I asked about all the stuff I'd need to know if I tested (God forbid) HIV +.

If the sum of all fears actually is that you have 'the virus' then see it as something that your body needs to fight not as a foregone conclusion! So take your medicine! Its two tablets a day for the rest of your days. In your country of origin this medicine is normally free.

In LOS I think its 1000 baht+ a month?

A buddy of mine was sleeping with his gf of six months, had loads of sex etc. Only to discover that she had HIV+. He went for the test... all clear, waited 3 months... all clear. He told me this and I wouldn't believe him at first. But he explained that if it was made common knowledge how tricky it can be to catch HIV+ from women via sex then it could cause a rise in promiscious behaviour.

Whether he's right or not I don't know but stay safe out there!

[Prakanong]

"If you are uncircumcised you can 'cheat' circumcision by exposing your foreskin and putting up with a few days discomfort. This will make infection and absorbtion less likely."

Are you 100% about this?

I will double check but I am pretty certain its about the cell types in the inside of the foreskin rather than anything like roughness or insensitivity which a cheating circ could only do.

I have had this chapter and verse from my Dr pal who i drink with very regularly - I work in pharma so sometimes discuss issues we have read in journals

As I am not a clinician I need to check this out with one but i am wary of your hypothesis

"He told me this and I wouldn't believe him at first. But he explained that if it was made common knowledge how tricky it can be to catch HIV+ from women via sex then it could cause a rise in promiscious behaviour."

Of course any public health information would not advertise this fact. I mentioned my pal getting HIV above. The Dr I worked with who I put him in touch with was the Medical Director for HIV research for a certain pharma in Europe - his words to me? "Your friend was very unlucky"

Edited May 10, 2007 by Prakanong

[anonaccount]

Thanks for the replies. I read up a bit and understand that my chance of infection is quite small. Especially since I am not even sure if the girl has hiv. However, there is still a chance.

It's hard for me to put things in perspective with something so serious as this. I guess I don't have the mental maturity to keep my anxiety in check. Anyways, I was reading up more today and the specific test is called "PCR". It is apparently extremely accurate after 28 days and can actually detect HIV much sooner...sometimes within several days of exposure. Anyone know if Bumrungrad does PCR tests?

[rainman]

Are you sure you even had sex with her? If you can't remember things anymore from that night, its quite possible she rocked back and forth on the pillow, held up a condom and said "we done darling" and you were a happy camper!

Anyways, hopefully this will remind you next time to drink a bit less before jumping out of the airplane while not wearing a parachute.

[Ijustwannateach]

As other posters have said, you can't be out of the woods for at least several months (and there are vanishingly small chances that you could be infected and not show it for years). There's nothing that can reduce your chance to zero except never having had sex (or perhaps not having had it for a couple of decades). Even condoms do not reduce the risk to zero. Sex is dangerous- but properly done, less dangerous than crossing a busy street in Bangkok (I'm guessing). Keep things in perspective.

[britmaveric]

No use worrying about it - get tested in 3 months and then proceed from there. Chances are rather remote, but best to be on the safe side. Slippage/breakage does occur just one of those things in life - shi*e happens.

[JimsKnight]

I'll PM you Prakanong, otherwise the thread will ramble off at a tangent.

[Prakanong]

I'll PM you Prakanong, otherwise the thread will ramble off at a tangent.

PM'ed you back

The Dr I ask all these sort of questions to at work is travelling this week (He must think I am weird but he loves Thailand too)

Here is a bit from the article I alluded to though - others might find it interesting

http://www.bmj.com/cgi/content/full/320/7249/1592

How HIV enters the penis

About 70% of men infected with HIV have acquired the virus through vaginal sex, and a smaller number have acquired it from insertive anal intercourse.7 Thus, on a global scale most men who are HIV positive have acquired the virus via the penis. This raises questions of how HIV enters the penis and why men who are uncircumcised are potentially more susceptible to becoming infected with HIV.

The uncircumcised penis consists of the penile shaft, glans, urethral meatus, inner and outer surface of the foreskin, and the frenulum, the thin band connecting the inner foreskin to the ventral aspect of the glans. A keratinised, stratified squamous epithelium covers the penile shaft and outer surface of the foreskin. This provides a protective barrier against HIV infection. In contrast, the inner mucosal surface of the foreskin is not keratinised15 and is rich in Langerhans' cells,10 making it particularly susceptible to the virus. This is particularly important because during heterosexual intercourse the foreskin is pulled back down the shaft of the penis, and the whole inner surface of the foreskin is exposed to vaginal secretions, providing a large area where HIV transmission could take place.

There is controversy about whether the epithelium of the glans in uncircumcised men is keratinised; some authors claim that it is not,15 but we have examined the glans of seven circumcised and six uncircumcised men, and found the epithelia to be equally keratinised. In circumcised males only the distal penile urethra is lined with a mucosal epithelium. However, this is unlikely to be a common site of infection because it contains comparatively few Langerhans' cells.10

Ulcerative or inflammatory lesions of the penile urethra, foreskin, frenulum, or glans that are caused by other sexually transmitted infections may provide additional potential routes for HIV transmission. In uncircumcised males, the highly vascular frenulum is particularly susceptible to trauma during intercourse, and lesions produced by other sexually transmitted infections commonly occur there. Thus, male circumcision further reduces the risk of infection by reducing the synergy that normally exists between HIV and other sexually transmitted infections.5

Conclusions

Of the estimated 50 million people infected with HIV worldwide, about half are men, most of whom have become infected through their penises. The inner surface of the foreskin, which is rich in HIV receptors, and the frenulum, a common site for trauma and other sexually transmitted infections, must be regarded as the most probable sites for viral entry in primary HIV infection in men. Although condoms must remain the first choice for preventing the sexual transmission of HIV, they are often not used consistently or correctly, they may break during use, and there may be strong cultural and aesthetic objections to using them. Cultural and religious attitudes towards male circumcision are even more deeply held, but in the light of the evidence presented here circumcising males seems highly desirable, especially in countries with a high prevalence of HIV infection. Although neonatal circumcision is easy to perform, and has a low incidence of complications,16 it would be 15-20 years before a programme of circumcision had any effect on HIV transmission rates. Circumcision at puberty, as practised by many Muslim communities, would be the most immediately effective intervention for reducing HIV transmission since it would be done before young men are likely to become sexually active.

It may also be time to re-think the definition of "safe sex." Since the penis is the probable site of viral entry, neither infected semen nor vaginal secretions should be allowed to come in contact with the penis, particularly in uncircumcised males. Thus, mutual male masturbation during which a penis is exposed to the potentially infected semen of another male should be regarded as risky sexual behaviour.

New preventive strategies are needed that could be used by men or women before the onset of intercourse. The disadvantage of topical virucides, such as nonoxinol 9, is that they may cause local irritation and thus increase susceptibility to HIV infection. The development of topically active agents that could block HIV binding sites, such as CCR5, and which could be applied to the penis or vagina to create a "chemical condom," might be more effective and acceptable than any mechanical barrier or surgical intervention.

[pluto_manibo]

You might want to find this girl again and offer to pay for her Hiv test, most girls will agree to this, as it doesn't come out of their pockets. It will not give you a 100% guarantee but it will atleast give you piece of mind until you get your test done. If your exposure was less then 72 hrs ago, you can take a post eposure treatment for one month at a cost of 10,000 baht...You might want to check this site out...www.medhelp.com....Although some of the views are controversial, the doctors are quite knowledegeable and have great experiences in their fields...They say that 90% of modern tests will give accurate results at 6 weeks and most people who have been infected serconvert before the 35 day mark.

[PeaceBlondie]

Are you sure you even had sex with her? If you can't remember things anymore from that night, its quite possible she rocked back and forth on the pillow, held up a condom and said "we done darling" and you were a happy camper!

Anyways, hopefully this will remind you next time to drink a bit less before jumping out of the airplane while not wearing a parachute.

Rainman and I sometimes disagree about sexual issues, but these remarks gave me my biggest laugh of the week. That's why I never have alcohol or drugs before sex. I may regret some of the things I've done, but I don't forget who I've done what with.

[anonaccount]

You might want to find this girl again and offer to pay for her Hiv test, most girls will agree to this, as it doesn't come out of their pockets. It will not give you a 100% guarantee but it will atleast give you piece of mind until you get your test done.

Yea,

Thats what I was thinking of doing. But I assumed bar girls don't like to be tested for HIV. If they test positive, the run the risk of not being able to work at their bar anymore.

[Prakanong]

You might want to find this girl again and offer to pay for her Hiv test, most girls will agree to this, as it doesn't come out of their pockets. It will not give you a 100% guarantee but it will atleast give you piece of mind until you get your test done.

Yea,

Thats what I was thinking of doing. But I assumed bar girls don't like to be tested for HIV. If they test positive, the run the risk of not being able to work at their bar anymore.

How would their bar know unless you told them?

I have never known a girl that minded being tested.

What I do know though is that when the girl I mention above who infected a pal discovered she was HIV + it came out which bar's would still accept girls who were positive and that others went to new bars who were depserate for new girls - this was in Pattaya

[PeaceBlondie]

I apologize if my joking about Rainman's comment was inappropriate. But, just as surely as a guy should always use condoms for sex, he should also have his wits about him, enough to know what he's doing. I have a friend who doesn't mix drinking and sex, especially because he has better sex when sober, and safer sex.

It's not just HIV, either. There are dozens of STD's that you can get from intercourse. They have different incubation periods, different blood or urine tests, etc. A clinic that can give one test can probably give most tests. I've heard that if there's no urethral problems, they don't do the urine test.

[anonaccount]

I apologize if my joking about Rainman's comment was inappropriate. But, just as surely as a guy should always use condoms for sex, he should also have his wits about him, enough to know what he's doing. I have a friend who doesn't mix drinking and sex, especially because he has better sex when sober, and safer sex.

It's not just HIV, either. There are dozens of STD's that you can get from intercourse. They have different incubation periods, different blood or urine tests, etc. A clinic that can give one test can probably give most tests. I've heard that if there's no urethral problems, they don't do the urine test.

No offence taken. It's not a catch-22 per-se, but I would never of had sex with the girl if I wasn't plastered....Regardless, it boils down to poor judgement.

Prakanong, thanks for the medhelp link. It's comforting to read information from an actual specialist.

[katana]

Some figures from the net:

From Wikipedia, a man has a 1/2000 chance of contracting HIV during one sexual encounter of vaginal intercourse (without condom) with an HIV+ woman.

For comparison with other STDs, Answers.com gives a much higher 30-50% chance of contracting eg syphilis from an infected person in the early stages of the disease during unprotected sex.

So chance of infection seems low (but nevertheless there).

[ProThaiExpat]

Having "come out" before the aids epidemic started in the early 80"s and having lived in Los Angeles during most of those years, I have "lived" and been in the high risk group in the HIV epidemic and have lost more than a few friends and ex's to the disease.

Ignorance was rampant in the early days, many advising not to be tested to avoid government invasion of privacy.

The overriding dogma of the 80's and 90's emanating from governments and health care providers was almost "use a condom or die". It was very much driven by the "fear" factor, as an effective health care message to fight an epidemic.

Since the turn of the century, I have seen a great many more websites and discussions that mirror the advice given to me in the very early 80's from a physician friend, who was one of the early specialists in treating HIV among gay males.

He told me privately, that the chance of becoming infected with HIV from sex with an infected person, if you do not receive bodily fluids in your body, for the male is 1/10th of 1%. Heresy in the two decades when it was a killer disease, but now many websites, including the San Francisco General Hospital website speak in these terms, as Katana did.

The fear prevails and you will encounter many highly fearful people who live under this umbrella of fear. As time goes on and the disease becomes less of a killer, attitudes change and now many put the risk in perspective with the actual reality. A circumcised male, without open lesions, with prompt post sex hygiene who doesn't take bodily fluids into his body is very unlikely to become infected with HIV. Especially if HIV status is determined prior to intercourse.

I remember much bad information being promulgated in the "old days" like: HIV laying dormant and undetectable with testing for 10 years, lamb skin condoms that "leaked" through osmotic action and were therefore unsafe, contracting HIV through oral sex so an oral dam should be worn for that form of sex, HIV from toilet seats, hand shakes, kissing, ad nauseum.

I heartily agree that condom use with anonymous sex partners is a must, probably more to guard against STD's, than infection with the HIV virus, assuming you don't receive bodily fluids. The foregoing is based on my personal experience as a very sexually active gay male who remains HIV negative to this day, and who was last tested four months ago. My motto is "don't get it nor give it" and you know of what I speak.

Many will disagree with my physician friend spoken of before who said to me "HIV is a difficult disease to contract", since it is a fluid carried virus that requires an almost direct pathway to the blood supply to be transmitted. Time and my own personal experience has proven him right in my view and yes, I expect many flames to come from politically correct posters.

[PeaceBlondie]

Agreeing with PTE - having sex is not a certain death sentence. I recall being counselled by a veteran, gay advisor in the USA, who said that even some receivers of fluid (orally) stood a low chance of contracting HIV, assuming they had no open lesions in the mouth. His less experienced fellow counsellor was advising my boyfriend at the same time, quite the opposite!

Back more to the topic of the OP: straight or gay, if you have unprotected sex while you're drunk or semi-conscious, with an unknown sex partner, that's much more risky.

[leisurely]

I think I would be more concerned about getting hepatitis B than HIV. We have some friends - a doctor couple working for the UN on AIDS research. They have both told me that it is a rather difficult virus to catch unlike hepatitis or syph.

[jinjok]

all the girls are sick, just to varrying degrees. from nsu to hiv and everything in between. walk into any chemist - what do you see? the girls will all tell you they are fine - they never get checked. its all bullshit.

hiv is of course the death sentence but there is also>

warts, herpes, hep a-b-c, syph and drippy dick. then you can move on to candesa (sp), thrush...

the list is endless.

the girl wont take a test. in thailand you have to give your name, even if you pay. only anon place i know is the red cross in bkk.

i would recommend you give a few weeks and have general tests. there are no real tests for herpes/warts in thailand (wait for outbreak). if youre sick, you can get the medicaine fast and cheap but give a few weeks to present.

when youre back home - you can possible get a hiv dna test done which will tell you within thirty days (th eporn stars get this all the time, its about us100). best you just go to a free clinic and get one done at 100 and 170 days BUT NO SEX TILL THEN OR YOULL NEVER REALLY KNOW (only on that oncident and prior).

people that say hiv is difficult to contract - that may be in a general sense. you can tell it to the millions that have it already.

thai fem prostitutes are thought to be about 8-15% positive.

i separate my sex and drinking and this is one of the reasons, things go wrong and when they do - its your life. its a gold rule.

sex in afternoon - drinking at night :-)

good luck and know weve all had a condom break on us. having said that... you never here from the guys that get really sick - they just fade away.

[britmaveric]

Dunno about not testing - large majority of bars require it. The ladies carry a book and need a stamp in it every couple weeks to keep working showing neg results. Least that was my understanding from a convo I had with a few bar owners on that topic.

[JimsKnight]

Yeah, HIV, from what I've read, is a delicate virus outside a host organism, Hep A/B/C on the other hand can survive for days on end at a time whereas HIVs lifespan (outside a host) is much less.

Now when I lived in Hua Hin the bargirls there had a doctor who visited the bars to do blood tests, whenever a girl who refused the test she was shunned by the others.

For us guys the danger-women are those that feel they should take revenge on all men that they sleep with because one guy infected them with (insert STD of choice here). They may try and 'slide off' the condom mid-coitus to try and then 'punish' the man they are with by passing on the infection. This can happen anywhere BTW, not just Thailand and not just bargirls. A women in N. Ireland got banged up (put in prison) for deliberately infecting young dudes she'd seduce. This happened about four years ago. Some guys do the same tactic too.

[silverhawk_usa]

You might want to find this girl again and offer to pay for her Hiv test, most girls will agree to this, as it doesn't come out of their pockets. It will not give you a 100% guarantee but it will atleast give you piece of mind until you get your test done.

This would not give you much peace of mine. Although she may not be positive now, She would also have to wait 3 months from her last sexual contact for the result to be reliable. So if she had sex with someone the day before you, she would be waiting only 1 day less than you for a reliable result. Might as well just wait for your results and skip the problems of dealing with her.

[Dakhar]

What I find perplexing is the amount of anxiety the OP is going to go through.... but to these girls, they do this every day. How do they go though life? I am not saying the anxiety is not founded, I just do not see how these girls blow off HIV/STD's as if it is a musquito bite.

[Forkinhades]

you can go into almost any bar, and ask to see the HIV test that the girls have had done, but of course there is still the 3 month window. Having said that you should always wear a condom.

[sabaijai]

lamb skin condoms that "leaked" through osmotic action and were therefore unsafe

Reference please? I thought most health experts were still unequivocally stating that lambskin condoms were not effective in the prevention of sexually transmitted diseases.

[ProThaiExpat]

The protocol I read had the lambskins hanging up for 24 hours with fluids in them, yes they oozed through osmosis.

When I have time, I will try to research the issue, but if you would use your common sense, how else would they ooze except by osmosis and how long does that take?

I doubt you will see a warning label on lambskins that say they are not effective in blocking HIV transmission. Imagine the lawsuits if they were not effective.