This was a no-risk event in regard to HIV.  First, few female sex workers in the US have HIV -- probably under a 1% chance, more likely somewhere around 1 chance in a thousand. Second, there has never been a reported and scientifically documented case of HIV transmission by cunnilingus, in either direction; and oral exposure to HIV (e.g. swallowing infected blood) is always low risk. The risk for fellatio, oral to penile transmission, has been calculated at 1 chance in 20,000, if the oral partner has HIV. That's equivalent to receiving BJs daily by infected partners for 55 years before transmission would be likely. And if we accept even a high chance your partner had HIV, i.e. 1%, it becomes once in 5500 years. I hope you'll agree this is zero risk for all practical purposes.

1) That covers question 1. I agree absolutely that this was a zero risk event that does not warrant HIV testing.

2) The risk of other STDs was somewhat higher, but still low for all infections, so you can rely for sure on those results. The rest of this question goes back to HIV, but I really have nothing more to say. There was no need for the tests you had, as the Med Express doc advised.  That said, the least reliable of all kinds of HIV tests is the Oraquick oral fluids test. Even after 3 months, it misses 2-5% of HIV infections, i.e. is never truly conclusive. However, with two negative results I would put the reliability value at 99%. Given the essentially zero risk nature of the exposure described, I am 100% confident you do not have HIV. But if you require a truly conclusive test result, you should have an AgAb (antigen-antibody, formerly "4th generation" blood test. I some how I were in your situation, I wouldn't feel the need -- but if I were an anxious type, an AgAb test is the one I would have.

I hope these comments have been helpful. Let me know if anything isn't clear.

HHH, MD

I'll give you a couple of examples, which I know will be hard to assess just over this message.  Orally, I have developed a yellow tongue and I'm now assuming that it is thrush.  Also, I have noticed a white nodule on the back underside of my tongue.  It isn't painful.  I have no idea how long it was been there, but I noticed it when examining my tongue for thrush.  Have you ever heard of an Oral Lymphoepithelial Cyst?  I found information on it stating that newly HIV patients can have it.  It is rare but from looking at the pictures online - it matches what my white nodule looks like.  It has completely scared me to death.

I know you said that I had no risk and the situation did not even warrant testing, but given the presence of these two things in my mouth, does that change your opinion? 

Thank you again!

I would strongly suggest that you stop searching the internet for HIV or STI symptoms. Anxious persons tend to be drawn to alarming information. In any case, the large majority of conditions that CAN be associated with HIV are "nonspecific" -- meaning that they do not point to HIV or any other particular cause. If you pick 100 symptoms experienced by humans at any particular time, over half of them commonly appear in HIV, mostly in overt AIDS. Looking at AIDS symptoms and then worrrying about them simply isn't worth it at this time. Trust me on this:  there is no possiiblity you have from the exposure you describe. 

If the oral bump or coated tongue continue to concern you, see a doctor. But please do your best to not worry about HIV!

Not that I haven't believed you, but I am really suffering mentally over this.  Since our first correspondence I have taken 2 more Oraquick tests (both negative).  To summarize, since my potential exposure, I have now had a total of 4 negative Oraquick tests at 43 days (6 weeks), 50 days (7 weeks), 54 days and 55 days.  Lastly, I took your advice on seeking further confirmation and visited a health department also on day 55, which was yesterday and had a blood drawn 4th generation test.  It was the most up to date test offered.  I just received a negative result from that as well.  The person administering the blood draw said that those who test at 8 weeks (I was 1 day shy of the 8 week mark) and beyond - the test is highly reliable.  They mentioned to me me that I can get further testing as much as I want down the road for peace of mind.  It certainly made me feel better since I am afraid of the accuracy of the Oraquick tests, however despite them not being as accurate, 4 negatives seem pretty solid.  

I understand that this is the last reply that I am allowed so I wanted to nail down a few things:

1) If I am showing potential symptoms (I have a white tongue, nodule on back of tongue, sore feet at times, sore armpits, periodic upset stomach) and HIV indeed was the issue, would my blood drawn 4th generation test have been positive?  Curious if you can have HIV like symptoms, yet HIV not show up on a test.  

2) If I took the blood drawn test again at 90 days, are the results likely to change?  

3) Finally, how conclusive is this 4th generation at 1 day shy of 8 weeks?  

I can't thank you enough for your time and input - despite my paranoia, your words/expertise really are helping.  Many thanks again!

1) The test results overrule these or any other symptoms you might have now or in the future. And no, you cannot have HIV symptoms with negative test results. And remember, you had a zero risk event in regard to HIV risk!

2) Don't do it. Waste of money, time and emotional endergy.

3) The AgAb (4th generation) HIV blood tests are 100% conclusive at 6 weeks. That's why there is no point in another test at 90 days. (The 3 month or 90 day advice you can often find online is old news, going back to older tests before the AgAb tests were available. Ignore any and all such advice.

Perhaps you'd also like to know that in the 15 years of this plus our previous forum, with thousands of questions from persons worried about HIV, not one questioner turned out to have caught HIV. You certainly will not be the first. If and when it happens, I'm confident it will be from a truly risky event, not a non-exposure event of the sort you had.

That indeed concludes this thread. See a doctor in person if you require still more reassurance. And stop worrying about HIV! I hope these comments help you do that. Good luck.