[Question #9667] HIV RISK?

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30 months ago
Hello doctors,

I met a transgender escort at a massage parlour on the 16th of January 2023 There we engaged in mutual condom protected oral sex and there was no condom preakage.There was no penetrative sex in this meet as well. I am a male btw.

Later I asked her about her health status and she showed me test results dated 3 January 2023 which showed she was negative for HIV.

On the 24th of Jan I had a case of vomiting and diarrhoea which I suspect might be due to food poisoning but my mind thinks it might be related to ARS. Currently it is Day 26 and I have a pimple in the back of my head close to what I think as per google reference is the  occipital lymph nodes.

Up until now I have not had any fever or rash or cough. I am planning to go for a test next week for peace of mind.
With the way life is at the moment I am stressed and anxious about this.

What is my risk of HIV infection?
What are the chances my result can be positive?
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Edward W. Hook M.D.
30 months ago
Welcome to our Forum and thanks for your implied confidence in your service.  I'll be glad to comment.  The encounter you describe was virtually no risk.  Your partner provided evidence that she was not infected with HIV on January 3 2023 and having not become infected up to that point there is little chance that she was infected in the interval since her prior test.  In addition, your exposures included both giving and receiving fellatio;  There are no proven cases of HIV acquired through receipt of oral sex from an infected person and the average risk of acquiring HIV from performing HIV on an infected partner is less than 1 infection for every 10,000 encounters (i.e. 99.99% of exposures will NOT lead to infection).  Putting all of this information together, there is virtually no risk that you were infected by your encounter on January 16.  

Nausea and vomiting are not recognized as parts of the ARS, nor are pustules (pimples).

Your risk for HIV is virtually zero.  If you choose to test, at 4 weeks (28 days) over 99% of persons with recently acquired HIV will have positive tests so, if you decide to test, the negative result that I am confident you will get will provide still further proof that you were not infected.  

I hope this perspective is reassuring.  I am confident, based on the information you provided, that you did not acquire HIV from your January 16 encounter.  EWH.  
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30 months ago
Hello Dr Hook, Firstly thank you for your advice. i just have a few further questions.
 You say "average risk of acquiring HIV from performing HIV on an infected partner is less than 1 infection for every 10,000 encounters". If you could what which acts were you refering to in this?

Also can ARS symptoms start after day 28? I ask this because since yesterday I have started having on and off pain in my left armpit and the back of my neck. I have tried to feel for any swollen lymph in the armpit but cannot find one. I am also having very slight pain in the throat when i swallow.

As i stated earlier this event is causing me a great deal of stress and anxiety. Could this be a cause of the symptoms?
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Edward W. Hook M.D.
30 months ago
I apologize for the lack of clarity in my answer.  IF your partner had untreated HIV (unlikely), there is no known risk for infection from receiving UNPROTECTED oral sex and the risk of infection from performing UNPROTECTED oral sex on an untreated, infected partner is estimated to be less than one infection per 10,000 exposures.  Your encounter was virtually no risk from a statistical perspective.  Please don’t worry.  EWH ---