[Question #1287] Anxious Please help

49 months ago
Ok
49 months ago
I had an ecounter with a prostitute it was masturbation and she spit on me once for lubrication am I at risk for hiv? I know spit isn't supposed to transmit but them why do they test for hiv through saliva?  Im freaking out I had a full panel done at 26 days including a 4th generation test and everything was negative I just can't stop thinking that there could have been a speck of blood on the spit which went straight into my urethra 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
Welcome to the forum. Thanks for your confidence in our services.

First, in the US, most sex workers do not have HIV -- well under 1% are infected. Second, HIV is rarely if ever transmitted by saliva. Even oral sex to completion has never been proved to result in mouth to penis HIV transmission. Speculating that "a speck of blood" entered your urethra is pointless:  even that would be no significant risk of HIV. Finally and most important, the 4th generation HIV tests are 100% conclusive at 4 weeks. Even if you had had a risky exposure, the test result proves you weren't infected. 

You don't say what other STD tests were done, but probably those also are conclusive, especially if you had a urine or urethral swab test for gonorrhea and chlamydia. In any case, the risk of these and any other STD also was very low. This event need not worry you any longer.

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

HHH, MD

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49 months ago
Ok so it is possible for spit to transmit?  Also what about the the fact that hiv is tested for through saliva? Also most sites say nothing is conclusive until 12-13 weeks...thanks for the info
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
I already said saliva (spit) doesn't transmit HIV. 

The oral fluids HIV tests are designed not to test saliva, but crevicular fluid -- i.e. seepage from around the teeth. Second, the oral fluids test is for antibody, i.e. the body's immune reaction to HIV. A positive result on that test does not mean the virus itself is present.

As for timing to positive tests, "most sites" are just being very conservative, or they haven't yet updated their advice. Three months to conclusive results is old news, dating back to HIV antibody tests no longer in use. With the antigen-antibody tests -- that is, the 4th generation tests like you had -- it's 4 weeks. Even for standalone antibody tests (3rd genration), it's 6-8 weeks.

So really, you don't need to be worried about this. If somehow I had been in your situation, I would not have been tested at all and would have continued unprotected sex with my wife, with no worry about infecting her.


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49 months ago
Thanks for the info Doc it has definitely helped I've been on other forums and they've basically said same things but it's more reassuring coming from you I've just got to get over this speck of blood thing that keeps popping up in my mind
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
Even with blood exposure, HIV is harder to transmit than you seem to think. When a woman with HIV, unprotected vaginal sex during menstruation has little or no elevated risk of HIV transmission to her male partners. The transmission chance is roughly once per 1,000 exposures -- and of course that involves hundreds of time more than a "speck" of blood contact with the urethra.

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49 months ago
Thanks again so I guess I should trust the results at 26 days? And yes everything thing else was negative as well this was stupidest thing I've done in my life I hope it doesn't end it
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
49 months ago
"I guess I should trust the results at 26 days?" Yes. Although 4 weeks (28 days) is officially conclusive, there is no plausible difference between 26 and 28. In fact, the test is nearly conclusive by about 15 days.

Don't beat yourself up over a very human sexual decision you happen to regret, especially since you had entirely safe sex.

We're beyond the two follow-up comments and replies included with each question, so that closes this thread. Take care and stay safe.

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