[Question #13787] Protected oral follow up…HIV risk
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17 days ago
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Hey doctors I’m so sorry for doing this but my mind is spiralling. This is in regards to the most recent exposure I had. I had a protected oral encounter. It lasted no more than 7 to 10 minutes and I did not ejaculate at all from my knowledge. The condom was on and did not break or leak. The issue I am now having is no longer STD risks it is now on HIV. I have read countless of questions from individuals on this form about oral HIV risk and I have seen that your guys responses are always the same but for whatever reason I feel as though I might be the exception. I know it’s probably anxiety more than anything, but I don’t know what else to do. So here are my questions and I hope that you guys are able to help me my birthday is tomorrow and I just wish I could enjoy it without concerning myself if possible HIV risk.
1. Am I at risk for HIV?
2. My Wife has been wanting to have sex, but I have been avoiding it just because I don’t want to hurt her with a possible HIV risk. I do want to test with a 4th GEN hiv test but that won’t be until probably Monday where I will be at the 4 week mark. I’ve read extensively on this form that four weeks is essentially 99% conclusive is that still correct?
3. Can I continue with my normal sex life with my wife or should I wait for the negative result?
4. Have you guys ever encountered an individual (through your years of medical experience from either your years of medical practice or yours years of responding to questions like mine) that has been positive from recipient of protected oral sex of HIV.
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17 days ago
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I understand that feeling I have is more out of guilt than anything else and I’m trying my best to resolve the guilt as I can. And I believe the only way I can is through a negative HIV test that you guys are the most respected HIV/STD doctors out there? I just want to hear from you guys. I’m sorry for my ridiculous questions I’m sure it’s laughable. I just wanna be sure.
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Edward W. Hook M.D.
17 days ago
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This is your 3rd anxiety/guilt driven set of questions in the past 3 weeks. My answers are not going to change. You can certainly test if you feel the need but in my opinion what you need is to seek formal counseling to address your ongoing guilt. You do not know that your partner had HIV or any other STI, your exposure was condom protected, and there had NEVER been a case of HIV proven to have resulted from receipt of oral sex, unprotected or otherwise. You are not at risk for HIV If you must prove this to yourself, an HIV RNA PCR test any time more than 11 days following your encounter will be conclusive, as well a 4th generation HIV antigen/antibody test at any time more than 6 weeks after the encounter. However you test, the result will be negative. Thus:
1. No
2. A 4 week test is more than 98% conclusive. A PCR test would be conclusive at this time (see above).
3. Yu can continue to have unprotected sex with your wife without fear that you have HIV.
4. Never
You have two follow-ups remaining. After completion of this thread, the thread will be closed and no follow-ups will be considered. Should you try to start a new question, it may be closed without a response and without return of your posting fee. This is being done out of concern for you, nothing more. Please seek counseling. EWH
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17 days ago
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Dr. Hook,
Thank you for your direct and consistent responses. I understand your conclusion clearly For my own education (not to dispute your assessment), I was hoping you could briefly explain the biological reasons why HIV transmission is not possible from receipt of oral sex, especially when a condom is used. Specifically, what barriers or conditions prevent transmission in this scenario I think understanding the mechanism will help me fully internalise what you’ve already explained and move forward.
Thank you again for your time and professionalism.
1. If I was to test on Friday which would be the 26th day would it matter much if I tested 2 days earlier than my 4 week mark (28th day)?
2. With a 4 week 98% conclusive test can I trust the results at that point or should I get a 6 week test? Ik testing is a personal choice but if u say I don’t need it then I won’t and I will believe my 4 week results.
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Edward W. Hook M.D.
17 days ago
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Sigh. Briefly, condoms are a physical barrier to HIV transmission. HIV infection does not appear to occur through the oral mucosal- this may be due to the characteristics of the mucosa (different body sites are more or less vulnerable to infection. The oral mucosa is regularly exposed to a variety of bacteria and viruses which do not go on to cause infection.
1. 2 days will not make a meaningful different.
2. From a scientific perspective, you didn't need testing to begin with. Testing at 6 weeks will not change the negative result that you will get at 4 weeks.
One follow-up remaining. After that further anxiety-driven, "what if" questions will not be accepted. You need counseling, not testing. EWH
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17 days ago
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Thank you for taking the time to respond and for your clear evidence-based explanations. I truly appreciate your patience, professionalism, and the reassurance you and Dr. Handsfield have provided me. and I recognize that the remaining issue is anxiety rather than medical risk. This will be my final contact regarding this matter. Please extend my thanks as well to Dr. Handsfield for his expertise and time. I am grateful for the work you both do and for the guidance you’ve given me. I don’t want to waste your time anymore than I already have. Sorry for my anxiety driven questions and u may close this thread. Thank you!
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Edward W. Hook M.D.
17 days ago
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Closing the thread now. There should be no need to return. Again, for your sake, please seek counseling. EWH ---