[Question #3761] need some advise

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87 months ago
hi everyone I would like to run some numbers by you, and hopefully get some insigth. I tested a year ago for hiv, shyphillis and chlamidya(negative), during this year I have had 5 diferent encounters with five diferent woman, 2 of this encounters where only reciving oral sex unprotected (im a male by the way) and the remainig 3 where reciving oral sex unprotected and the proceeded to vaginal sex with condom, until done. So here is the way I see it, I live in a city in mexico that has 900,000 persons, where the oficial HIV site here in mexico, confirms that there are 5,000 persons living with hiv BUT THIS NUMBER IS OF THE WHOLE STATE not just the city, the population of the whole state is 2 million persons but just to be pessimistic lets keep only the city population, out of the 900,000 persons lets get rid of 350,000 persons that are not sexually active( children and the eldery) that leaves us with 550,000 persons in the city. But we also have to look at the 5,000 number, because Im a heterosexual and the oficial site of HIV of my state confirms that out of that 5,000 persons with hiv 4,053 are men !!!!! wich leave us with 947 woman and if we cut in half the 550,000 asuming half are men and half are woman this means that out of the 275,000 woman in my city the  .3% have hiv. So now on to my exposures lets say ONE of the five woman I was involved with was hiv positive, what would be my chances of contracting hiv from reciving unprotected oral sex ?  what do you make doctors of my numbers and my exposures ?  
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Edward W. Hook M.D.
86 months ago
Welcome to the Forum.  I'll be glad to comment and congratulate you on your practice of safe sex.  I think that your estimates are conservative and to estimate that 3 out of every 1000 women in your city has HIV is, if anything, a bit high.  Further, even if one of your sex partners in the past year had HIV, I see no reason for concern. You indicate that your genital-genital contact was condom protected and therefore safe (even if a condom was not used, HIV is transmitted less than once in every 1000 sexual encounters in this sort of situation). 

This leaves your receipt of unprotected oral sex.  This too was safe sex.  There are NO proven cases in which someone has acquired HIV from receipt of unprotected oral sex from an infected sex partner.  You are not going to be the first. 

Thus, to summarize, the exposures you describe were virtually no risk for HIV.  I see no reason at all for concern about the exposures you have described.  I hope this comment is helpful  EWH
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86 months ago
thank you doctor I also think 3 out of 1,000 woman is a bit high, especially since most of the persons with hiv in my city are men, I have a couple of questions for you doctor 1- Do you believe that 5 sexual partners in a one year period is high ? especially since I only had protected vaginal sex with 3 of them ? 2- Regarding ARS someone can have none of the symptoms or all of them, in my particular case I have only experince sore throat for the las 2 months, in your expert knowledge, do you believe if I was experince ars a continous sore throath would be the ONLY symptom I would be expericing  ? 3- During vaginal sex with one of the woman there was a little bllod from her period, so we stop she went and grab a towel to clean the small amount of blood from my penis still with the condom on and then she continue with giving me oral sex, since I was a bit drunk after 3 minutes she finally took the condom off and finish giving me oral sex until I came  outside, COULD she have some residue of blood in her mouth from where she was giving oral still with the condom and after cleaning with the towel befor e? 4-Why if saliva is not infectious for hiv, The oraquick swab test istaken from saliva ? 5-I have spent the last two months reading the POZ forums, but I focused only in the RECIVING oral sex posts, but that they also post their TEST results I already found more than 150 posts with all negative results and some of them with a confirm hiv + partner 6-I read a story about a couple where one was hiv+ and they only engaged on condom protected sex and the HIV + PARTNER gave his partner oral sex and not the way around, and they remain negative until now more than 10 years, so this gives me some peace of mind7- Do you know of patients that only engaged on reciving oral sex and never became positive doctor ? I really dont believe in fact any of the five girls had hiv but again if one had it my only exposure would have been recipt of oral sex 
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Edward W. Hook M.D.
86 months ago
Straight to your many questions:

1.  Many is a relative term.  men tend to have more sex partners than women and younger men have more sex partners than older men. Vaginal sex with three women over the course of a year is not exceptionally high.
2.  A sore throat without other symptoms is not the ARS.  The ARS is a syndrome which included high fevers, sore throat, muscle and joint aches among other symptoms.
3.  No one has ever gotten HIV from receipt of oral sex, even when persons have blood or sores in their mouth.  I would not worry about the situation you describe.
4.  The Oraquick detects antibodies to the virus, not the virus.  There may be small amounts of virus in oral secretions but that does not change the FACT that there are NO PROVEN CASES of HIV acquired through receipt of oral sex.  You are not going to be the first.
5.  Agree.  See comment 4 above.
6.  Understood
7.  Again, see reply number 4 above.

I agree that receipt of oral sex is essentially a no risk event in terms of HIV risk.  I hope this information is helpful to you.  EWH
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