[Question #11506] Hiv risk

14 months ago

Hello doctors, sorry for my English, I come again because of a risk I had with a girl and I want an evaluation. 5 days ago I had insertive oral sex without a condom and vaginal sex with a condom. I asked the girl if she had any illness and she said no, but I don't know her and I have my doubts because she told me that she once had a threesome with 2 men, she told me that one was a doctor and that he was her boyfriend. and he gave her tests including HIV, but that was 2 years ago, but I am very suspicious because he gave me oral sex without protection, I made that mistake, my question is: what is my risk of contracting HIV assuming that the girl has it and If I should get an HIV test.

H. Hunter Handsfield, MD

14 months ago

Welcome back to the forum. Thanks for your continued confidence in our services.

You describe a partner who almost certainly does not have HIV or any other STIs; and even if she did, you had safe sex with her. There has never been a proved case of HIV transmitted oral to penis. And condoms are excellent protection against HIV and other STIs. From a risk standpoint, you definitely do not need testing. Indeed, we generally advised that nobody needs to be tested after any single sexual exposure unless the risk is a lot higher, e.g. unprotected with a known infected partner. A much smarter plan is to disregard individual exposures and have regular HIV testing from time to time, like every 6-12 months, depending on frequency of new partners over that time.

Of course you are free to be tested anyway -- that's your choice. If somehow I were in your situation, I wouldn't do it, but if you decide to be tested, have an antigen-antibody test (AgAb, "4th generation") blood test 6 weeks after the event. You also could consider a urine gonorrhea/chlamydia test, but in absence of symptoms it is extremely unlikely you caught either of these.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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14 months ago

I completely understand, I really don't want to take tests and this time I tried to take all possible precautions not to do it, however I think I shouldn't have done oral sex without a condom, at the moment I don't have any symptoms, maybe I'll take the test after 42 days if I were to experience something unusual in my body. A moment ago I asked the girl again if she is clean and she told me not to worry, but she is 20 years old, I think she is young to understand certain things. Thank you for your advice, doctor, I am now calmer, I will use my next follow-up question in case I need it later. Just to confirm, are you completely sure that I can continue with my life and ignore this encounter as a possible contagion risk?

H. Hunter Handsfield, MD

14 months ago

Don't criticize yourself for not using a condom for oral sex. It's not a routine safe sex recommendation, although of course people are free to make their own choices about it.

Most sexually active persons -- even twenty year olds -- are pretty good at understanding their STD risks. That doesn't guarantee your partner isn't infected, but it lowers the odds.

No, not "completely sure": of course I cannot guarantee that you are at zero risk from the exposure described. But if somehow I were in your situation, I wouldn't be worried and would be continuing unprotected sex with my wife without concern.

FYI, the opportunity for follow-up comments is for clarification of the original question, not entirely new issues. Threads are closed after two follow-up comments and replies or 4 weeks, whichever comes first.

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14 months ago

I understand, so to close this conversation just answer these questions:

1. Has it been scientifically proven that saliva is not a route of infection for HIV? 2. Are there documented cases in which there has been infection due to this type of risk, have you even had one in your clinic or patients?

3. If in this case the girl has mouth problems that cause bleeding, does that increase the risk?

4. You are completely sure that I do not need a test for this risk? .

Finally, thank you very much Dr. Hansfield, sorry if you find the questions a little repetitive. kind regards.

H. Hunter Handsfield, MD

13 months ago

With apology, I'm only noticing these follow-up questions as I review older threads in order to close them. I hope you see this. I'll leave the thread open a few more days just in case.

1,2. That there are no known cases would be considered by many to be sufficient proof. But all we can say for sure is that there are no known cases, and that if saliva exposure ever results in HIV, it is extremely rare. To my knowledge, there have been no such cases in our clinics.

3. Oral bleeding obviously has little effect. Oral bleeding is pretty common, i.e. millions of persons potentially exposed to HIV -- and still no known cases.

4. Yes, I am sure. If somehow I were in your situation, I would not be tested. But of course you are free to be tested if the negative test result would increase your reassurance about it.

Apolgies again for the long delayed reply.

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13 months ago

Hola doctor, gracias por su respuesta, ya no tengo dudas, ya ha pasado más de un mes y no he sentido ninguna anormalidad en mi cuerpo ni ningún síntoma. He decidido no hacerme ningún examen, creo que no lo necesito y tampoco quiero hacerlo. Muchas gracias nuevamente, puede cerrar esta conversación cuando quiera. Saludos!

H. Hunter Handsfield, MD

13 months ago

Gracias por las gracias. Me alegro de haber ayudado. ---