[Question #6303] HIV worry

15 months ago
Hello Dr,
I have an issue that's been tormenting me:
June 8: on a trip to Berlin I made the mistake of calling an escort. Found the ad online and the woman (30yo from Taiwan) was "delivered" to my room.
We engaged in unprotected fellatio, me (male 37y) as receiver, for 1-2 min. and after that protected vaginal intercourse for not much longer. 
The condom was on from the beginning of intercourse + NO ejaculation. I withdrew after just a couple of minutes and I'm 100% certain the condom was still intact and covered “everything”.
I went home to resume my life with my family (m. 2015, dating since 2011. No other “adventures”).
Approx. 1w after my son and my wife both got ill with tonsillitis/streptococcal infection that was diagnosed on a clinic and both of them were put on phenoxymethylpenicillin.
Symptoms: Severe sore throat and mild fever (38,2-5).
On june 26 (18 days after exposure) I started exp. same symptoms. A really sore throat and also a fever of 38,2-3. I was otherwise feeling "fine", no rash, no swollen lymph nodes.
We had a vacation coming up on june 30 so I figured it was just as well I got to see the doctor too, to get my own cure and speed up my recovery. I thought I had the same thing as my wife and child so I borrowed 2 doses of my wife's cure and took acc. Instructions.
The day after I had my appoint. The Dr took my temp, examined my throat and felt under my chin and told me that I did NOT qualify for a strep. test.  She would take one since my wife and child was affected.
I was tested – NO strep. inf!
I asked her what was wrong with me, then? She said she didn't know, "probably some virus infection"
Went on vacation. Fever gone 1-2 days after, sore throat a couple of days later).
It wasn't until we got back home is struck me - could that "virus infection" be HIV? My mind began to go crazy. I stupidly went online googling my situation from every angle I could possibly imagine, scaring myself more and more ever since.
QUESTION : From a MEDICAL point of view, am I in any risk of having been infected with HIV from exposure above?

Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

Welcome to our Forum and thanks for your questions.  I happened to be on the site soon after your question arrived and so you are getting a response far more quickly than usual. Any follow-ups may take longer.  Let me provide the bottom line first, then follow with explanations.  Your exposure was a no risk event for HIV.  No testing was or is needed.  Now for the details:

1.  Your exposure.  Your exposure was a virtually no risk event.  If your partner is Berlin was licensed, you can be confident she did not have HIV as commercial sex workers in Germany are checked regularly.  Even if she was not licensed, most CSWs still do not have HIV.  Further, there are no proven cases on which a person has gotten HIV from receipt of fellatio and condom protected sex is safe sex (remember that for genital sex, even unprotected sex with an infected partner leads to infection on average less than once in every 1000 sex acts.  With a condom that figure becomes less than 1 on in a million encounters.  .

2.  Your wife and son's strep. Strep throats are highly contagious within families.  One person got it and likely gave it to the other.

3. Your symptoms and negative test.  Taking your wife's medications likely made your strep test negative.  Any symptoms you had may or may not have been due to step- taking the antibiotics makes it hard to prove. 

Bottom line.  I see no medical or scientific reason for concern about HIV. Similarly, I see no medical reason for testing.  If you choose to test (always up to you) for the reassurance that a negative test will provide (and I am confident your test would be negative), your test will be negative. 

I hope these comments are helpful.  EWH

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15 months ago
They were. And thank you so so much for your quick response, and for your reassuring words.

I've been worried sick and I "know" I suffer from some kind of hypochondria where I subconsciously (?) search, and find, evidence for a current illness everywhere I look. It has happened before but not like this.

My deepest concern was always my negative strep test and whether I myself was to blame for it beeing negativ. Since you're telling me it's a possibility (even likely?) everything else starts to make sense as well.

And since you're also telling me that this was a NO risk event and that I don't even need testing (from a medical point of view) I will do myself I favour and try to stay off the internet in this matter from now on.

Once again, thank you so much. 

I wish you a pleasant day.
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

Your strep test could have well be negative because of the antibiotics you took. alternatively, you may have had a non-STI viral sore throat. Either way, there is simply no realistic reason to think that your sore throat was related to your CSW encounter in Berlin.  Please do not worry about this as a possibility- it is not.

I also agree and totally support your decision to stay off of the internet.  EWH

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15 months ago
Thanks. I'll try to do that. Although, since I have one question left I guess it's best to make use of that one as well:

Based on above, can I rest assure that any "symptoms" that I might "experience" (imagine) now or in the future are in no way related to this episode? If I know myself I'm afraid I will take any sign (i.e. swollen nodes in the throat/neck, an oral ulcer or something else that is most likely due to an unrelated common infection) as symptoms of HIV in action.


Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago
This is a repetitive question.  As I said in my first reply, there is no medical or scientific reason for you to be worried about HIV from the events you described.  Repeating the question does not change the answer.  As I also said, if you need further reassurance, ge t tested (I am confident that if you do, your test will be negative).  Try not to  assign undue meaning to the sorts of aches, pains, and sniffles we all get from time to time to be a consequence of your dalliance.

This will. Omelette this thread which will be closed shortly without further responses.  EWH


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15 months ago
My apologies. Message noted. I'll follow your advice + signing out.  Thank you.