What should I do?

[jhguy011]

I think that this is an anxiety issue that I should have dealt with a while ago, but I was in a monogamous relationship for nine months.  Monogamy relieved a lot of my worries about HIV transmission and the risk of transmitting other STDs, but then all the old fears flooded back when I broke up with my long-term boyfriend and had some sexual encounters again.
I jerked off with three different guys.  I know you say this is zero risk.  There were the usual things that worry people like me: pre-ejaculate fluid and semen being used as lubricant and getting near my urethra.  I know though that you say this is still zero risk because HIV does not stay intact well outside its environment for long at all.

Two different guys, I gave head to.  Neither one of them ejaculated into my mouth, but one did have a lot of pre-***.  With the second guy, I also had chapped lips, so there was a healing crack in my bottom lip.  I know, I know again.  This does not really factor into any greater risk.  But I obsess over it.  I know that you still consider this low to zero risk for HIV transmission.  Why does the CDC say that "some cases have occurred" from transmission of HIV through oral sex when a lot of HIV educators on the forums say that no such case has ever occurred? Who is wrong?

I, in fear of causing more damaging anxiety to myself, will not even dare to read what possible symptoms could occur if you transmit HIV.  However, I have been sick twice in the last two weeks.  Once, I had a fever, chills, and stomach ache.  This time, my throat hurts when I swallow and my lymph nodes are painful.  I know, I know.  These are most likely separate things that are just happening because of the season.  But I am so scared.

I'm tired of being scared.  I've been living in fear for a month now.  What can you tell me?

Thank you for patiently reading,

Scared in Columbus, Ohio

[H. Hunter Handsfield, M.D.]

Well, I wish I could help you with your anxiety problem.  But all any forum like this can do is provide facts, probabilities, and our interpretation of the available data, plus perspectives on the controversies.  You obviously have seen many of my and Dr. Hook's comments, so you know what I'm going to say -- and yet your anxieties persist despite knowing that the exposures you describe carry virtually no risk of HIV.

You also know that CDC and other government agencies have to take conservative stances.  Further, even if certain exposures can, rarely, result in transmission, it doesn't change the advice because the risk is so low as to be meaningless.  By the way, the uncertainty and apparent disagreement about oral sex transmission risks are for mouth to oral.  There is no disagreement that HIV transmission can occur from the penile partner to an oral partner, if the penile partner is infected.  But your risk remains exceedingly low, even if your partners had HIV, which probably they did not.

For these reasons, I'm sure I could spend half an hour constructing a very comprehensive reply to all the specific issues stated or implied by your question, but I'm not going to do it -- because I'm sure it will make no difference.  When someone has intellectual knowledge about risks ("left brain") yet that knowledge doesn't connect to reduce anxieties and allow balanced perspectives ("right brain"), the resolution doesn't come from repeating the facts.

If you haven't done it, have an HIV test a few weeks after the last oral exposure to help prove to yourself you weren't infected.  Then seek professional mental health care to deal with the main problem here, which you recognize yourself.

There is no point in continuing discussion. I'm not going to have anything else to say.  But I hope this much helps.

Best wishes--  HHH, MD

[jhguy011]

Well, thank you, doctor.  I appreciate your answers.

[H. Hunter Handsfield, M.D.]

Not related.  Use a little objectivity.  Let's say ever month 100,000 people get symptoms like you describe.  And let's assume a million people participate in oral sex.  By random chance, each month there will be several thousand people who experience both events, with not the slightest implication that one caused the other.  You're just one of those people, nothing more.  I haven't a clue whether those numbers are correct -- but you get the idea.

Please accept the common sense explanation and the reassurance you have been given.  Stop trying to talk me (and yourself) into believing there was risk of HIV.  There was not.

I won't have any more comments on this thread.

[jhguy011]

I guess I would not be so freaked out if I had not continued to get sick.  Do my symptoms from my two bouts of colds or what not seem unrelated to you?  If so, why?