[Question #4273] Anxiety

32 months ago
I am a straight female, but my family member had AIDS, so my anxiety surrounding contracting this disease is slightly high, and maybe a little irrational. So, I'm hoping you can answer a few questions for me to give me some insight/make me feel better.

A free clinic near me uses the 1-minute Rapid finger prick test. How many weeks past exposure is this test accurate? I have seen so many different responses that say from 4 weeks to 3 months.

How likely is it to contract HIV from oral sex? I had discussed STDs with my partner before any sexual activity, but cannot help but to be slightly paranoid that he could've lied. I've read that saliva can kill/weaken the virus, but I had a painless canker sore like sore in my mouth at the time, which was caused by my braces.

Lastly, why do some people experience symptoms, and others do not? Like mentioned above I had a sore in my mouth, well, I have recently been getting these more than normal, and can't help but be concerned that they are somehow an extremely mild symptom of HIV.

I know that technically my chances of acquiring this are low as I'm a straight female who only has sexual relations with straight males, but I live in a large metropolitan city and can't get over the fear that somehow this will make its way back to me. I do not sleep with many people, and am always protected, but was not protected with aforementioned oral sex with my ex-boyfriend. Thanks in advance for your answers. 
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Welcome to our Forum.  I note that you used past tense regarding your family member with AIDS so this person may have expired.  If so, I'm sorry for your loss.  I know that when HIV strikes close to home, concerns and anxieties tend to be amplified.  I'll do my best to help.

The convenience of the rapid tests is that results can be made available while the person being tested is still present in clinic, eliminating the need to wait for results.  These tests however are slightly less sensitive for detection of infection than lab based tests and may take a little longer to become positive.  In general however these tests provide highly reliable results when used at any time more than 12 weeks after an exposure.  In contrast, lab-based combination HIV antigen//antibody tests provide entirely reliable results any time more than 6weeks after an exposure.  

Oral sex is an inefficient way for HIV to be transmitted.  Even the most conservative estimates suggest that HIV is transmitted on average only about once in every 10,000 acts of performing oral sex (I.e. Like performing oral sex on an infected man every day for over 27 years).  The risk for infection fro. Receiving oral sex is even lower risk than performing it.  I have never heard of or sen a person acquire HIV from receipt of oral sex.

Why some people get Symptoms with recently acquired HIV and others do not is unknown.  As the infection progresses over many years, symptoms become more common but they are still uncommon until people have been infected for many years.  Oral sore/ulcers are a common problem and are not a particularly common sign of HIV.  If you have tested negative recently I would not worry that you have HIV causing your oral ulcers.  On the per hand, if you have not tested, getting tested may be worthwhile if it will give you peace of mind.

I hope my comments are helpful.  If anything is unclear or there are other questions, please don't hesitate to use your up to 2 follow-up questions for clarification.  EWH




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31 months ago
Yes, my family member passed away a few years ago. Thank you for your condolences. Your response was extremely helpful, thank you. I was tested by the finger prick around 6 weeks post any potential exposure. I plan to get a blood test soon to confirm, since it the previous test is most reliable around 3-months. I'm assuming this test will be negative, but it would be a nice relief to have final confirmation.

I do have an additional question if you're able to answer it. My anxiety isn't just around HIV, but all STD's in general. Today I got a Brazilian wax, and ever since I can't stop worrying about the possibility of getting herpes from this situation. Had I thought through my anxieties around this before, I wouldn't have even gotten it. So, my question is, is there a possibility of contracting HSV from a wax? The woman used a soft wax that she scooped out with wooden sticks (like a tongue depressor). She used a new stick with each application, but IF by chance she "double-dipped" with a client before me, could HSV survive in the wax? The wax was warm, but not scolding hot, so I would assume that it was not warm enough to kill the virus? I understand that my fears around this are probably irrational, but I really appreciate your insight. Thank you so much! 
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
I'm pleased that my comments were helpful to you. 

In reading your follow-up question, as well as perhaps reading between the lines for your earlier comments, I wonder if you may be more concerned than is necessary.  STIs, including HIV are really not all that common, not are they all that easy to catch.  Most people, even most people with risky life-styles however you choose to define that, do not have STIs, including HIV and even when they do, even most unprotected sexual exposures do not lead to infection.  Thus, practicing safe sex and making wise decisions will protect you from most STIs.  We recommend that all clients go for periodic sexual health checks which include screening for STIs, particularly when they have multiple partners or are starting new relationships.  This is not an judgement but simply acknowledgement that most people have had other partners in the past, that many STIs can occur without symptoms, and that while it is unlikely that you are infected, knowing this based on negative tests will provide a measure of confidence and, when both partners have been tested, trust as their relationship moves forward.  We routinely recommend this for new relationships and suggest that such testing should include testing for gonorrhea, chlamydia and for the woman and sometimes the man, depending on the test performed, tests for trichamonas using either vaginal swabs of for the male a urine test.  Testing for HIV and syphilis, while far, far less likely can be easily added with a blood test if desired.  We specifically recommend against blood tests for herpes unless one partner has a history of the infection as they have relatively frequent false positive test results and can be misleading. In the US confidential testing can be obtained for little cost at health departments.


With regard to your Brazilian wax, I would not worry.  Environment exposures and infections related to them are virtually non-existent.  STI pathogens, including HIV are fragile and die quickly on exposure to chemicals (like the wax), to air, or to other environmental factors. 


I hope these comments are helpful.  EWH


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