Doctors, thank you for your continued good work.  You settled my mind after a single encounter with a gay man three years ago, which turned out to be a no-risk encounter, but your patience and wisdom allowed me to move on with my life without the oppressive weight of anxiety.  

I have had a second a few weeks ago, and I would like to ask for your assistance once again.  I performed oral on a gay man without a condom.  The man is in his early 20’s and in the military, so tested regularly.  In fact, he mentioned that he was tested in May and admitted to having sexual partners since, but always used condoms. I performed oral more on a dare.  We bonded over having served on the same ship (at vastly different times) and knowing he was gay, mentioned my single, condom-related oral, three years prior.  I know the reasons don’t matter, so I won’t belabor them here but know that it was truly a one-off and I don’t plan on having another.  I have had no other exposures.

Your forum teaches many visitors to assess risks well.  Although I knew it was kind of silly to perform oral in this circumstance, having read your forum so often some years ago, I asked all of the questions about testing and risk ahead of time and conducted some quick mental math.  Odds of contracting HIV from oral 1/10,000… Odds of the partner having contracted HIV since May… 1/1,000?  Total odds 1/10,000,000? Perhaps it’s ridiculous, but assessing the odds helps with anxiety.

The partner, who I would regularly see in town and on social media, is strangely absent and now my mind has gone into overdrive.  The ship will not leave port for many months and he mentioned that he had no leave remaining. So, in my mind, he contracted HIV and has been separated from the military…. Because, of course, he has, the anxiety monster in my mind says so.  Since he was tested in May, it likely means that he was seroconverting during our encounter (because again, of course, he must have been). So, now my mind is doing the mental gymnastics and thrown out the 1/1,000 for the partner having HIV, and, due to the high viral load that the anxiety monster insists in there, turns my 1/10,000 odds against being infected by performing oral, to 1/1,428 (high viral load elevates the risk 7x?).  So, the anxiety monster says if I get cancer with a 1% survival rate, I’m dead, it also says that if I have a 99.93% chance of NOT contracting HIV, of course, I will be infected… What is it about the human condition to be fatalistic?

Bless you for your patience if you’re still reading this, on to my questions:

1.     How would you assess my risk in this encounter?  (1 in thousands? Millions?

2.     If you were somehow in my situation, would you get tested (not to satisfy the anxiety monster, purely for medical reasons? And by the way, I plan to be tested but again, your perspective helps)

3.     If you were somehow in my situation, would you continue having sex with your wife without worry?

I’ve read in your posts that in the 15+ years (more now?) you have yet to have a confirmed positive HIV case.  I hope that holds true and that I will not be the first, but the anxiety monster says difference, because of course he does.

Thank you for your patience, understanding, and your service to so many of us who struggle with our missteps.

Thank you for the response, I’m just shy of 3 weeks post exposure, so I’m unable to test at this time with conclusive results.  As you’ve advised all visitors on many occasions, I’ve avoided general web searches looking for more information, but I have what I would guess are trusted sites.  While I know this is likely inadvisable, my situation hasn’t changed, and my anxiety is piqued.  I believe you once stated in a post that when speaking with a colleague, it was postulated that 90% of this sites visitors, visit due to anxiety (yup).  But not only is it cost effective, as your post mentioned, few resources can compare to the tremendous knowledge and experience you and Dr. Hook bring to the table, so Thank You!

My follow-up questions:

1.     Would you consider TheBody a trusted site for accurate information?  This article (HIV Transmission and Risk: Separating Fact From Fiction) seemed mostly consistent with your and Dr. Hook’s advice, but also provides a bit of a different take on the risk attributed to Oral Sex (which is calming, if accurate)

2.     The CDC no longer stated a numerical risk factor for oral sex, but lists it as “Little to No Risk”, along with medical care, biting, and deep open-mouth kissing (among others). Would I be putting you out of I asked whether you agree with the risk being 1/10,000; or if this risk is really far less, but for lack of another estimate, 1/10,000 is still used?

3.     How rare is rare?  The numbers are reassuring but so is your experience. Have you or Dr. Hook ever has a patient that could realistically attribute contracting HIV to performing oral sex?

4.     I reviewed your work in MedHelp, you and Dr. Hook have been helping people for a long time, my sincere thanks for your service, and I’m sure that’s shared by many others.  I’m not sure you would be pleased with how MedHelp answers questions today, the answers don’t seem to be sourced from professionals and the moderators do not have strong credentials (not a question but thought you might be interested)

5.     Would you consider testing at 4 weeks to be conclusive?  I believe you’ve mentioned 6 weeks, and also that neither you nor Dr. Hook have seen or heard of a case that was negative at 4 weeks and the patient turned out to be positive.

I do know that anxiety driven questions are exasperating for both you and Dr. Hook, but I sincerely appreciate your patience and your thoughtful responses.  When anxiety prevents me from eating and sleeping, your feedback helps me stay centred on fact, and not hysteria.

I’m hopeful that my odds remain extremely remote.  I’ll save my third post to share my test results once conducted.

As always, my sincere thanks for all you do!

Dr. Hansfield,

As I’m sure you were expecting, my tests came back negative. I am overwhelmed and exhausted.

While I appreciate the opportunity to share my good news with you, moreover, I wanted to take one more opportunity to express my sincere and heartfelt gratitude to you. The practical and considerate guidance that you and Dr. Hook offer to thousands of concerned people across the world is unmatched by anyone. 

The tiny investment in asking a question can in no way compensate you for your worth; I realize it truly is a selfless lifelong passion for helping people that have inspired you to help so many.

While I don’t expect we will correspond again, please know I will remain endlessly grateful to you for helping me through my gaffe. You are a saint of a man. If I’m ever lucky enough to meet you, I look forward to shaking your hand and expressing my most sincere gratitude. Please know that I am a hugger, so I may get caught up in emotion and catch you in a bear hug to express my thanks.

Don’t be concerned if you’re not a hugger. I’ve never been to the Pacific Northwest, so the odds of you not being swept up in a bear-hug are very much in your favor, but not zero. However, intellectually, you can consider it zero for all practical purposes. 

Again, my sincere and heartfelt thanks.