Concerned about exposure

[dkinohio10]

Dear sir,

5 days ago I did oral sex on a woman and mutual masterbation. During masterbation I penetrated her maybe twice and did ejaculate in her. That evening I was lighheaded and nauscious. My mind is starting to wonder if I have contracted HIV. Two time's prior we have had sex and both times a condom was worn. I did however at both prior times give and receive oral sex.

According to her, she ( 34 yrs old ) has only been with 4 men one of which she was married to.  She had stated she was tested years ago, but that was years ago.

Should I just quit worrying about this and stop looking online at statistics and symptoms?

[Edward W Hook, MD]

You are partially correct.  Actually there are a few cases in which writers have suggested that HIV might have been transmitted through oral sex however critical evaluation of these reports is unconvincing.  In working with persons with and at risk for HIV since the epidemic was first recognized, neither of us on this Forum has ever seen a convincing case of HIV transmission through oral sex, nor have we heard of such a case.  There is also NO data to support the idea that gum disease, bleeding gums, mouth sores or dental work increase this risk.  EWH

[dkinohio10]

Thank you for your prompt reply. I do have one more question though.  From everything I have read, there has never been a documented case of HIV being aquired through oral sex.  Is this  true?  If so, is this true for both receiving oral sex and giving cunnilingus?

I have also read that if you have dental problems ( Gingivitus, recent dental work, etc.) that your chances of getting HIV through oral sex are greatly increased?

Just curious...

P.S. - I forgot to mention yesterday that she gets blood work done every 6 months for thyroid issues.  I do not know if this has any bearing on your answer above, but it is something I forgot to mention.

[Edward W Hook, MD]

Let get our terms clear.  Masturbation does not involve penetration. If your penetrated this partner, you had intercourse with her.  If you did not use a condom, it was unprotected.  With that as the basis for my advice, let's assess your risk for HIV.  It is low, here is why:

1.  Fewer than 1 in 1000 women have HIV.  Your partner had a relatively low to average number of past sexual partners and was 34, both of which make her risk somewhat lower than average.
2.  You had a single episode of unprotected genital sex with her.  IF SHE WAS INFECTED (very unlikely), her risk of transmitting infection to you is less than 1 infection per 1000 acts of intercourse.
3.  Oral sex is lower risk than genital sex and, in the setting you describe does not add significantly to your risk.
4.  Your symptoms are unrelated to HIV. HIV does not cause symptoms so quickly.

Putting these figures together, your risk of getting HIV from the encounter you describe is less than 1 in a million and probably considerably lower.

So, what should you do?
1.  Don't worry.
2.  Why not have the two of you get tested together.  If her test is negative, you cannot have been infected by her.  Similarly, a negative test for you will provide her with reassurance as well.
3.  If you do not want to follow suggestion number 2, you probably don't need testing but if you decide to, wait at least 6 weeks after the exposure you describe to get tested.  That will provide you with reliable proof that I am right and you did not get HIV.
4.  Stop looking at internet sites.  they contain much incorrect information.

Hope you find these suggestions helpful.  EWH