[Question #9674] Newfound panic

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30 months ago
Hello.  I am an admitted hypochondriac of a fairly extreme degree.  And I completely understand your position that fear of taking an HIV test is no excuse.  However, for people like me giving into every irrational fear and taking tests just feeds into our underlying problem and perpetuates our vicious cycle.  What has helped the last few years is arming myself with realistic knowledge so as to beat into my brain that I am overreacting and to stop living in fear (with all kinds of imagined health worries).  With regard to HIV, this is not something I have been worried about.  But for reasons not worth getting into, I’ve gotten it into my head to worry and panic about events that took place nearly 4 years ago.  So I’m hoping I can get some perspective and assurance so that I don’t start getting into a vicious cycle with this newfound worry.  Here is my summary:- 3 to 4 years ago I had a few instances of protected vaginal sex with CSWs (Dallas, TX and from accredited escort sites).  Uncircumcised.  Each time lasted no more than a few minutes, and the condom never broke.  Each time was also preceded with a few minutes of protected oral as well.  They all appeared to be clean and hygienic.  Here is the breakdown of visits:1.  Youngish lady, 1 minute protected intercourse2. Mature lady, 1 minute protected intercourse3. Mature lady, two separate instances of protected intercourse, each lasting a few minutes4. Mature lady, two separate instances of protected intercourse, each lasting a few minutes.  I do not recall having any ARS type symptoms.  It has now been nearly 4 years, and I’m sad to say that that I have not had intercourse since those encounters!  But given these details, along with the lack of ARS and my seemingly good health in the last four years, is it insanity at this point to start digging up fears from years ago?  Thank you so much in advance.
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Edward W. Hook M.D.
30 months ago
Welcome to our Forum.  thanks for your questions and your insightful self analysis.  I agree with you that there is no realistic medical need for testing.  To assist you, let me list the reasons I say this:

1.  HIV is actually quite rare in commercial sex workers, particularly those identified through escort services.  Further, they do a good job of getting tested for HIV and other STIs on a regular basis, probably fa far better job than others who might be encountered more casually.  
2.  Each of the encounters you describe was condom protected.  Condoms are highly effective for HIV and STI prevention unless they break.  You can be confident that your condoms did not break.  When condoms fail, they break wide open leaving no doubt that they failed.  
3.  Even if your encounters had been unprotected, and even if your one of your partners happened to be infected (neither of which is at all likely), your risk for infection would be VERY low- the estimated risk for acquiring HIV from a single unprotested vaginal sex act is less than 1 in 1,000 (i.e. 99.9% of encounters would NOT lead to infection) and there are NO proven cases of HIV acquired from the receipt of unprotected oral sex.  Thus your mathematical risk of infection, if one of your partners was infected would be less than 1 in tens of million, i.e. lower than your odds of being struck by lightening today.

I urge you not to worry and can say with great certainly that nothing that you have described above suggests any meaningful risk for HIV.  There is just no need for testing.  
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