[Question #727] HIV Risk

52 months ago
I am a male and had 2 encounters of mutual unprotected oral sex with a man of unknown status about 6-8 years ago. I was never tested and never had symptoms. More recently - about 16 months ago - I had an encounter with a trans csw which included protected anal (I was top) and mutual unprotected oral. (There was never any ejaculation in mouth during oral for any of the 3 total encounters). Aside from those episodes I have been in a monogamous relationship with a female. Around the time of my most recent msm encounter (16 mo. AgoI developed a ratch patch on my abdomin. This lasted up until the last few weeks when I was finally diagnosed with pityriasis versicoloured. Having the rash caused me to become extremely concerned about my past encounters and the potential for HIV. I've gone for testing but the 2 week wait is unbearable. I'm wondering if you can help me with a risk assessment with regard to my encounters and rash.
Edward W. Hook M.D.
Edward W. Hook M.D.
52 months ago

Welcome to the Forum.  I'll be pleased to comment.  Your risk for HIV is low.  Condom protected sex is safe sex you your rectal intercourse was safe as long as the condom was used throughout sex and did not break (if it had, I presume you would have mentioned it).  Receipt of oral sex is likewise virtually no risk as there are no reported instances in which a man has gotten HIV from receipt of oral sex form an infected partner.  Finally, your performance of unprotected oral sex on a male partner is very, very but not no risk.  there are a small number of cases in which men appear to have gotten HIV from performing fellatio on an infected partner.  These instances are so rare that we can only estimate the risk of infection associated with performing oral sex on an infected partner and that estimate is typically less than 1 infection per 10,000 exposures.  Since you do not know the HIV status of your partners, it is safe to assume that the likelihood that any of them were infected is less than 10%.  Using these numbers therefore, we can say that your mathematical risk of infection from your encounters with other men is less than 1 in 30,000 (three episodes of fellatio with unknown partners X less than 1/10 change of infection X less than 1/10,000 risk of infection if they were.  To put this in perspective, your risk of being hit by lightening is 3-4 times higher than your risk of getting HIV.  Your rash in no way changes this calculation. 

I hope this reply is helpful.  It is unclear to me why it should take two weeks for your HIV result however.  The test takes less than a day to perform so even with transport and recording factored in, your result should be back in about a week.  I would suggest you call and see if the result its back yet.  EWH

p.s.  This of course presumes that your female sex partner(s) do not have HIV.  Personally, I think you do not have much to worry about.  EWH

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52 months ago
Thank you, Doctor. I called and it is a 10 day wait period, not 2 weeks, but they won't share results even if they have them until the 10 days is up. There is no rapid testing in my area either unless you are deemed a very high risk. Your answer has helped a lot with my anxiety. I might even be able sleep tonight.
Edward W. Hook M.D.
Edward W. Hook M.D.
52 months ago
Thanks Jason.  I'm pleased I could help.  I also wish you could get your test sooner but am confident that it will be negative when you get it.  EWH
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