[Question #12937] Unprotected Oral sex and hiv

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3 months ago
Hi Doctor,
10 days back, i had an sexual exposure with sex worker, where she performed unprotected oral sex to me for less than 10 seconds, and then we did was protected oral and vaginal sex as i was scared of std/hiv concerns. 
Reason why i am scared as i found this person through online pages and she was okay doing unprotected oral and vaginal sex. I did not ask her hiv status. 
I didn't see any blood from her mouth also i am unaware of if she had any cuts or sores in her mouth. I tried reaching her but cant get in touch as the listing or number doesnt work.
I am scared of getting contact hiv, i had PCR RNA test  at 6.5  days when i went to my regular doctor. I have read through your forum for other questions answered. I have genital hsv1 but i dont get any more these episodes. Online on different medical guidelines it says, there is risk but it doesnt differentiate between risk of giving or receiving. 
Also, you have said in other answers there is no need to test, i am not sure why cdc says otherwise. 
I have anxiety where i cant perform my regular work. I do have many physical symptoms, have chills, dry mouth, getting up during night with chills.

Please advise. 
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3 months ago
To add to it, 
she rinsed her mouth with mouthwash before performing oral. Not sure if thats relevant, however read somewhere in medical notes online it may increase chances as it decreases the hypotonicity in saliva.
She was asian mid 40s. 
All studies/websites online only give about cases who performed oral sex on male partners and not the other way around. 

Also, Dr. Hunter and Dr. wood, say that it would take 55 years before getting the infection as chances are 1 in 20000. But if i have to say it can happen to anyone at any given exposure. Please correct me if am wrong
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Edward W. Hook M.D.
3 months ago
Welcome to the Forum. Thanks for your questions.  I'll be glad to comment 

I'm sorry for your anxiety but there is not much I can do about that.  I will provide some information which I hope will be helpful. The encounter you describe was very, very low risk.  You do not know if your partner had HIV or other STIs and the fact is that most people, including most commercial sex workers do NOT.  Further, receipt of unprotected oral sex or sex has NEVER been shown to be associated with acquistion of HIV and your unprotected exposure was VERY brief.  Condom protected sex is essentially safe sex.  

You are correct that the estimated risk of acquiring HIV from receipt of oral sex is estimated by the CDC to be in the range of 1 infection in 10,000 to 20,000 exposures but that is only and estimate by the CDC which tend so be conservative,.  As I told you, there are NO proven cases of HIV which have been acquire from receipt of oral sex.  

Your PCR test was too early to be of value in ruling out HIV.  HIV RNA PCR tests become conclusive after more than 11 days.  

My advice is not to worry.  I also urge you to stay away from the internet which is alarmist and contains much misinformation.  Whether you continue to test if, of course a personal choice. 

I hope this information is helpful.  If anything is unclear, you have up to 2 follow-ups for clarification.  EWH
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3 months ago
Hello Dr. Hook, thank you for the details, i want to update you i took a HIV 1/2 RNA qualitative at day 12 from exposure and result is non reactive. What are my chances that these results are false negative at day 12. 
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Edward W. Hook M.D.
3 months ago
Thank you for the additional information. The results of your HIV. RNA. PCR test are conclusive. You did not acquire HIV. There is no reason for further testing. EWH.---
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3 months ago
Hello Doctor, thank you for your reply.
i am still trying to move on, however want to know what are the chances that my result is false negative at day 12. As some medical journals says its only 50% conclusive and to be completely conclusive i need to retest around at month using PCR or do 4th gen Antigen/Antibody test at 45 days. What would you say to that. 

Also read articles and forum like poz where admin says no risk for getting a blowjob and person should move on.

In your work tenure, have you seen a false positive at day 12 for RNA PCT test. 
I apologize if my questions sounds repetitive, i am still feeling very anxious.
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Edward W. Hook M.D.
3 months ago
This will be my final response.  There should be no need to return with further questions.  If you do, the question may be closed without a reply and without return of your posting fee.

Your question is repetitive.  As I already informed you- "receipt of unprotected oral sex or sex has NEVER been shown to be associated with acquistion of HIV and your unprotected exposure was VERY brief.  Condom protected sex is essentially safe sex. "  Repeating the question will not change the answer.

As I already told you, results of HIV RNA PCR tests are conclusive ANY time after 11 days.  Your 12 day result is conclusive.  There is little chance that your result is falsely negative.

This thread is over. Please do not return.  I hope you will put your unwarranted, excessive anxiety aside.  EWH
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