[Question #7590] Worried about HIV from 4 year old encounter

2 months ago
Hi sir, 

I am a 33 year old married Indian guy and 4 years ago I had this encounter with a girl who was a friend. I received unprotected oral from her and had condom protected sex (Durex or Manforce) . I checked the condom afterwards and it was intact.
I have always been guilty about this incident but never really regarded it as important.
Also She smoked before this encounter, does that raise risk ?
Recently that friend broke all contacts with me for no reason and suddenly I became paranoid about a possible HIV exposure.
I have had normal unprotected sex with my wife in last 4 years and never been really sick or gotten any infection in last 4 years.

This was my only exposure  and It has me worried sick now.
We are planning to have a child now and suddenly this paranoia is not helping me.

I have read your advice about similar exposures on this forum and found this are virtually no risk.
I need your advice about this exposure and whether I can move on and plan on having a child and not fixate on this.
Please help.
Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago

Welcome to the Forum.  Thanks for the question.  I'll be glad to comment.  This was a virtually no risk encounter for HIV or other STI.  Most people do not have STIs or HIV.  Even when they do, most unprotected encounters do not lead to infection.  In the encounter you describe, your use of a condom transformed the encounter from low risk to no risk - i.e. condoms work as long as they do not break during use.  You condom did not break..  As for receipt of oral sex, there are no proven instances in which someone has acquired HIV from receipt of oral sex.  If the person performing oral sex is a smoker, this would have no impact on the risk for infection.

I see no reason for concern about HIV from the encounter you describe and would not worry.  Should you desire the assurance that a negative test would provide, testing once would be fine and would provide reliable results although personally I see no reason for testing related to the encounter you have described.

I hope this information is helpful.  Feel free to use your up to two follow-ups should any part of my response be unclear.  EWH

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2 months ago
Thanks a lot for your reassurance Doctor.
Few more things that I wanted to clarify :
  1. We also indulged in mouth to mouth kissing.
  2. I am uncircumsized.
  3. We moved to germany 2 years back and following incident happened here.
  4. Last year my wife had unusually late periods and spotting, we went to a Gyno and he did take blood samples and urine samples and said everything is alright and we can try for baby. I don't know though what tests he ran.
  5. Last months I maybe squeezed my penis too hard or rubbed it too hard and got swelling in my foreskin. Also felt urge to pee more and light burning after urination. I went to a urologist , he did ultrasound and urine tests and said all normal and no infection. The same problem happened again and I think its because I rubbed my penis too hard again
Can all of these incidents combined mean something and make any changes in your assessment ?
Or Is it ok If I decide to move on from that encounter without testing and plan a baby with my wife.
Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago
Thank you for the additional information. I happen to be on the form soon after your new questions arrived so you are receiving a reply a bit quicker that is typical. Straight to your follow-up questions:

1.  HIV is not transmitted through open mouth kissing or kissing of any sort. This is true even if one or both persons have dental problems, gum disease, or mouth sores. Still no risk.

2.  If your partner had untreated HIV (unlikely) or your genital sexual encounter was unprotected, the fact that you are uncircumcised would slightly increase your risk for infection. Among uncircumcised men, 99% of exposures to infected women do not result in infection. In your case, the encounter was condom protected making it still a no risk event.

3.  Understood.  If anything, the likelihood that your partner had HIV is lower in Germany than it would be in India.

4.  ETA be expected to cause weight. Or spotting between periods. I cannot comment on what tests might have been performed for your wife however testing for HIV or other STI‘s would not necessarily be part of the evaluation. For your information, in that you are working to become pregnant, here in the United StatesOur routely tested  for STIS and HIV.

5.  Understood.  I would not be worried about an STI in this situation.

In summary, none of the additional information you have provided changes my assessment or raises concern for HIV. I would not worry and encourage you to move on without continuing concern.  EWH 
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2 months ago
Thanks for your reply doctor. This would be my last follow up :

  1. I could not understand "ETA be expected to cause weight. Or spotting between periods."  and "For your information, in that you are working to become pregnant, here in the United StatesOur routely tested  for STIS and HIV."
  2. I might have used Durex ultra thin latex condom. Are those considered safe ? . Also these condom companies say these are not effective 100% of the times, does that raise risk for me ? 
  3. My main concern is that I pass something on to my wife. Although its too late to abstain from unprotected sex now that its been 4 years, you suggest I don't need to worry about it right and can continue to do so ?
  4. Although I asked the friend after our exposure and she said she is clean and not fucking around everyone. But my fear was what if she was unaware of her recent exposures.
  5. This has been my only exposure in all my life apart from my wife and I know my fears are caused primarily by guilt. Had I been single, I would not have worried about this at all.
I know I am overthinking this now. But I will move on based on your final comments.
And I thank you very much for your valuable suggestions for me.
Edward W. Hook M.D.
Edward W. Hook M.D.
2 months ago
I apologize for the typographical errors in my earlier response.  For clarification:

1.  This should have read that “HIV should not be considered as a cause of late periods or spotting between periods.”  The 2nd sentence was meant to inform you that while HIV and STI testing would not necessarily be part of evaluation for spotting or late periods, in the U.S. when women present for initial evaluation following becoming pregnant, they are routinely tested for STIS and HIV.  I do not know if this is usual practice in Germany.
2.  Durex condoms are a respected brand.  The cautionary statement that they are not 100% effective is standard and does not mean that you are at risk.
3.  To begin to abstain at this time would make no sense.  As I told you, your exposure was virtually no risk.  If you remain worried you could consider testing to prove to yourself that you do not have HIV although I am confident that you were not infected by the exposure you described.
4.  Understood.  See comment 3 above regarding howto address your unwarranted fears.
5.  Understood.  While I understand your feelings of guilt, this in no way changes my assessment or advice.

Please don’t worry.  Test if you must.  It is time for you to put this misstep behind you and move forward.

This completes this thread. EWH 
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