[Question #4323] Follow up on 4278

32 months ago
Just a follow up on #4278. I won't go into all the details again, as I'm aware there should be no repetitive anxiety-driven questions. This was in reference to mutual oral with another man. One time only. Some ejaculation got in mouth, but most did not. I made the mistake of checking out the internet and it made me wonder about HIV, despite the low risk. I did not have bleeding gums, but I did brush teeth earlier and I'm in the process of quitting a stupid habit of chewing tobacco- which I know is stupid and I'm quiting with the patch. Anyways, I am scheduled for a physical and having labs drawn on what would be the 27th day post exposure. I guess I'm just wondering if the risk is strong enough to warrant hiv testing, if you think I am over-reacting, and if a ag/an test on the 27th day given the risk level would be good. Is it still considered about 99 percent reliable? And would my brushing/stupid habit make me more at risk? Thank you very much. 
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Welcome back to the Forum.  I'm sorry that you continue to worry.  I believe your question is directed primarily at HIV so that is what I will comment on.  The estimated risk, even through conservative groups such as the CDC (whose perspective is that they cannot "afford" to be wrong) is that the risk for acquisition of acquiring HIV from receiving or performing HIV in an infected sex partner is less than 1 infection, IF that partner is infected.  There are a handful of documented instances in which persons have acquired HIV from performing oral sex on an infected partner but not enough in one place to even study systematically.   To my knowledge, there are still NO well documented cases in which a person has acquired HIV from receipt of oral sex.  There are no data to suggest that having brushed your teeth, gum disease, mouth sores or chewing tobacco increase risk for infection.  In my over 35 years of caring for persons with and at risk for STIs and HIV I have never seen a person who acquired HIV from giving or receiving oral sex.  You are not going to be the first.

Having said that, you are clearly worried.  For this reason, when you have your physical, my recommendation is to get an HIV test with a combination HIV antigen/antibody (4th generation) test.  there is virtually no risk of a false positive result and at 27 days this test will be more than 99% conclusive and the result should take your mind off things.  Even more importantly, I urge you to stay off the internet.

Hope this helps.  EWH. 
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32 months ago
Thank you, Doctor. It helps greatly to have someone of your expertise reply with such confidence. I will test this week at 27 days. Just as advice, would you consider this test enough to move on with no additional testing warranted given my situation? And in your expert opinion, testing would be good for peace of mind, but would maybe not otherwise even be needed for this single oral event?
With that, I will end and thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Correct on both counts.  To be honest, I see no need for testing.  Thus, you are testing primarily for your peace of mind.  When your 27 day test result is negative, as I'm confident it will be, I hope you will move forward without concern.  EWH---
32 months ago
Sorry for what is probably a silly question splitting hairs...due to a work commitment, my lab work may move to Thursday, which would be the 27th day, but technically 26 days and 9-10 hours post-event. I will move my labs to this time but I just wanted to be sure that you would still consider this 99 percent reliable and enough to not warrant any further testing following a single episode of mutual msm oral and move on with life and sex life. Sorry...just wanted to double check before scheduling. Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
there is no meaningful difference in the accuracy of a test result take at 26 days and 9-10 hours and a result taken at 27 or 28 days.  All will provide 99% reliable results and should be believed.  I have complete confidence that your results will be negative and when they are, I urge you to put your concerns aside and move forward.  At that time you will be in the clear.  As you probably know, we provide up to 3 responses to client questions on this Forum. I have now provided 3 respses. thus, this thread will be closed a little later today. Take care. EWH
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