[Question #11136] doubts about the HIV Risk
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16 months ago
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Dear Doctor(s):
I hope you are having a good day. i am a male living in Italy, who engaged last week with an escort from Ukraine. We engaged in kissing, somehow protected oral sex (at first she spitted on the head of my penis and gave me an oral for 3 seconds then i told her to use a condom), and protected vaginal sex. Also, we used the same condom for both vaginal and oral sex and ejaculated in her mouth.
the thing that keeps my mind busy is that, she was a little bit sick having a sore throat, also her mouth and vagina were so warm (i do not know whether it was fever or not) and having white tongue. So, i am afraid that she was experiencing ARS symptoms and viral load in this acute phase is extremely high.
1- can that spitting on the foreskin transmit HIV? (also she had a piercing on her tongue which constantly toucing the tip of penis)
2- although the condom covered the head of penis, some part of the shaft was in contact with vaginal fluid because condom was moving a little bit. is this a risk for hiv?
3- we used the same condom for both types of sex and we constantly moving from oral to vaginal and vaginal to oral sex. can this one cause the hiv transmission?
4- Do you think i need to be tested? although i think maybe she was recently turned + because i asked her and did not receive any other message (my last test was 3 months ago and did not have any sex until this one)
5- your final assumption and evaluation?
I appreciate your help in advance.
I hope you are having a good day. i am a male living in Italy, who engaged last week with an escort from Ukraine. We engaged in kissing, somehow protected oral sex (at first she spitted on the head of my penis and gave me an oral for 3 seconds then i told her to use a condom), and protected vaginal sex. Also, we used the same condom for both vaginal and oral sex and ejaculated in her mouth.
the thing that keeps my mind busy is that, she was a little bit sick having a sore throat, also her mouth and vagina were so warm (i do not know whether it was fever or not) and having white tongue. So, i am afraid that she was experiencing ARS symptoms and viral load in this acute phase is extremely high.
1- can that spitting on the foreskin transmit HIV? (also she had a piercing on her tongue which constantly toucing the tip of penis)
2- although the condom covered the head of penis, some part of the shaft was in contact with vaginal fluid because condom was moving a little bit. is this a risk for hiv?
3- we used the same condom for both types of sex and we constantly moving from oral to vaginal and vaginal to oral sex. can this one cause the hiv transmission?
4- Do you think i need to be tested? although i think maybe she was recently turned + because i asked her and did not receive any other message (my last test was 3 months ago and did not have any sex until this one)
5- your final assumption and evaluation?
I appreciate your help in advance.
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H. Hunter Handsfield, MD
16 months ago
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Welcome to the forum. Thank you for your question and your confidence in our services. I wish you a good day as well -- I think this reply will help you with that goal!
It is true that if your escort partner had a newly acquired HIV with symptoms, she would be highly infectious. But almost certainly she did not. The symptoms you ascribe to her really are not concerning for HIV, since it is a thousand times less likely as a cause of sore throat than garden variety upper respiratory viruses. As for her feeling warm to you, I suppose that could mean she had a fever -- but here too, other things are far more likely causes than HIV. If you were at risk for anything at all, it was for a common cold far more than for HIV. In addition, assuming "escort" means an expensive sex worker by appointment (as opposed to bar pick-ups, brothel workers, etc), she probably is at very low risk of HIV. Such women tend to be careful about their health, use condoms for vaginal sex, have mostly low risk partners (men like you!), and get tested frequently. Finally, even if she had acute HIV infection, saliva rarely if ever transmits the virus (saliva kills HIV).
Those comments pretty well cover your specific questions, but to answer them directly:
1) Saliva on your penis, including foreskin, is unlikely to transmit HIV, even if she were infected.
2) Condom protection for HIV depends on the head of the penis and meatus (urethral opening) being covered. Contact of the penile shaft with saliva (or vaginal fluids) is not likely to transmit the virus.
3) Using the same condom for both oral and vaginal sex does not significantly raise the risk of HIV transmission.
4) From a strictly medical or risk perspective, I see no need for you to have another HIV test at this time. That said, reassurance itself often is a valid reason for testing. If you're going to continue to worry and lose sleep despite my evaluation and advice, and if a negative test result would be more reassuring, feel free to do it. (This does not mean I believe there really was any signficant risk!)
5) My final judgment: You were not at significant risk of HIV and should not be worried about it. But feel free to be tested anyway if you remain worried. If you do that, you definitely can expect a negative result.
I hope these comments indeed help you have a great day! Let me know if anything isn't clear.
HHH, MD
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16 months ago
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Dear Doctor,
It was really helpful and brought me peace of mind. I would be grateful if you could answer the following questions:
1- if we consider she was infected, still my chance of getting infected is really low and near zero, right?
2- can i keep having unprotected sex with my girlfriend?
3- what would you do if you were in my situation? Would you not worry and keep on and not take the test or opposite?
I appreciate your help in advance
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H. Hunter Handsfield, MD
16 months ago
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1. Yes: little or no risk even if she has HIV.
2,3. If somehow I were in your situation, I would not worry, would not be tested, and would continue unprotected sex with my wife without worry.
However, that's not necessarily my advice to you. Re-read (5) above: you still might benefit from testing for reassurance.
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16 months ago
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I appreciate your help a lot Doctor. final questions:
1- Can i take a RNA test at day 11 and consider it conclusive? do you suggest another test?
2- at day 6 already experiencing some mouth sores and the lymph nodes in my pelvic area and armpit hurts occasionally but not swollen as i understood, these are not suggestive of Hiv, are they?
Thanks in advance and i hope you are having a good weekend.
1- Can i take a RNA test at day 11 and consider it conclusive? do you suggest another test?
2- at day 6 already experiencing some mouth sores and the lymph nodes in my pelvic area and armpit hurts occasionally but not swollen as i understood, these are not suggestive of Hiv, are they?
Thanks in advance and i hope you are having a good weekend.
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H. Hunter Handsfield, MD
16 months ago
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1. Honestly, I wouldn't spend the money on an RNA test. But if you do it, in theory 11 days is conclusive, but some experts advise 14 days "just in case".
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2. These are not likely to be the only symptoms or ARS, and ARS symptoms do not start sooner than 8 or 10 days.
Maybe it will also help you to know that in the 20 years of this and our preceding forum, with thousands of questions from persons worried about a possible HIV exposure, nobody has yet reported they tested positive. You will not be the first. If and when it happens, most likely it will be from a genuinely high risk exposure, which you did not have. (Like anal sex between men.)
That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
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