All of the odds against me? Cunilingus on a prostitute

[scared_aussie]

15 days ago, on the 14th of August, I performed unprotected oral sex on a Panamian prostitute (20 minutes). Now, the last thing I want to do is put my partner's life at risk.

I spent a whole week looking up on the internet risk factors etc. The reason why I am writing is because I believe I have all of the odds against me:

* I flossed 10 minutes before the episode (long story...)
* I had sore gums near my last tooth
* I was jet-lagged. I read that being jet-lagged lowers your immune system
* I have genital herpes (not sure what type - sorry)
* I byte my cheeks with my teeth. It's a "habit" I've had for a long time. However, that doesn't cause sores.
* She was a prostitute; however, her HIV status was unknown
* The day after, she told me that she had a sore throat and didn't feel very well the whole week.
* She didn't get especially wet during the episode; however, I didn't wash my mouth until the morning after.
* I was drunk. I read on the web that drinking alcohol increases the chances of infection
* She sent a message to my phone last week, saying "I am glad the test was negative. I am so happy for you. I love you lots, call me" (!)
* 10 days after the episode, I developed swollen armpit lymph nodes, and a weird skin sore on the middle toe of my right foot. Today, 2 weeks after the episode, I feel fatigued.
* Sex workers in Panama get tested weekly for STDs; however, apparently they don't do weekly HIV tests - it would be rather expensive, and there is the window anyway!

I talked to a local lab: they told me that they have the latest HIV tests (with P24), and that even after 2 weeks it is likely to give a positive result if I was indeed infected. They told me that I should go in 10 days (28 days after exposure) and then again for final confirmation after 2 months.

I am stressing out over this - a lot. I am finding it very, very hard to concentrate and to retain information. I have no access to counselling (I am still travelling). This site is my only harbour. I had cancer a while ago, and can tell you that fear of HIV is _worse_ than cancer. With cancer, there are (painful) cures. With HIV, it's like a slow death sentence, which is passed on to people in activities that are blissful otherwise. Also, cancer doesn't stop you from making  love, and it's not infectious... HIV really is the worst thing ever, and I needed this exposure to realise it.

Questions:

1) Is that true that there are no "documented" cases of HIV passed on giving oral sex to a woman?
2) If I were infected, would I be the first one?
3) Given the circumstances, are my chances still good?
4) What's the incidence of HIV+ female sex workers in Panama? A local paper had pretty horrific numbers. That article is what actually triggered my fear the day after.
5) Even if my chances are like 1 in 10000, it's still possible that I draw the "unlucky card" - right?
6) How long shall I have protected sex with my wife?
7) Should I tell the prostitute that I have genital herpes?

Thanks!

[tbleary]

A related discussion, Oral on a Woman: Total Panic was started.

[OMGWAL]

A related discussion, Cunilingus on a prostitute was started.

[scared_aussie]

Hi,

Thanks for keeping this thread open for me.
You can close it now: I am HIV-.

I am writing it here to give this a "closure".

What a huge waste of time,, energy, effort on my side.

Worried wells: LISTEN TO DR. H. REALLY, DO.

Bye everybody...

[scared_aussie]

Hello,

I have had my 7 week test. It's a 4th generation, p24/antibody test.
It was negative.

Dr. H, you seemed very definite about me not even needing testing. Well, I guess this proves you (once more) right.

However, I have had swollen amrpit lymph nodes and a slight, persistent sore throat for 4 weeks. Which other STDs would you test for? Shall I do a throat swab of some kind? I have never had anything like that.

THANK YOU DOC!

[scared_aussie]

Thanks a billion, doctor H.

I simply cannot describe how grateful I am. I normally have access to FREE, top quality health care in my own country (Australia). Before now, I didn't even know sites like this (Or Dr. Bob) existed.

In Australia, I feel privileged. However, thanks to doctors like you, this "privilege divide" can be broken. You offer your services, of a compassionate and skilled doctor, to all those people who for whatever reason (living in the wrong country, or travellers like me).

Well, thank you again. I will post my 6 week peace-of-mind test results, and then I will probably forget all about it. But I will never forget you.

[H. Hunter Handsfield, M.D.]

Almost certainly your symptoms have nothing at all to do with the sexual exposure you describe, just a coincidence, likely a respiratory virus.  There is no other STD that would cause them or that you need testing for.

HHH, MD

[scared_aussie]

Hello,

I got my HIV test results. It's a duo p24/antibodies, and it's negative.
I also tested my blood for clamydia, gonorrhoea, hep (can't remember the types). All negative.

Because of my sore throat, I also had a swab, and checked my throat for gonorrhoea and clamydia. They both came back negative.

The problem I am having is that I have very swollen and painful armpit lymph nodes and a bothersome sore throat. I have had those simptoms for about 3 weeks now (give or take). I had my lymph nodes checked with ultrasound, and the doctor said that it wasn't cancer but yes, they were severely inflamed.

These symptoms started about 10 or 14 days after my "exposure" (reminder: cunnilingus on prostitute).

I will report the results from my 6 week test. However, I have no access to a proper doctor where I am right now - and I won't until I get back home later next month. So... I realise that you *hate it* when people ask more questions, but... do you know which other STDs I should get checked? The sore throat is not caused by clamydia or gonorrhoea... could it be anything else?

I know it's not your area, but... do you know could make my armpit lymph nodes swallen and painful?

Thanks doctor!

[scared_aussie]

Hello,

This is for everybody, to see if other people here have had something similar.

Well, I have had a slight sore throat for 1 week. Also, for about 2 weeks the lymph nodes in my armpits have been heavily enlarged. Since I had cancer recently and am now in surveillance (fun, uh?), I went to the doctor to get them checked and I had an ultrasound: 4 lymph nodes in my right armpit, 2 in my left one. They are about 2 centimeters. It's not cancer, thankfully: the doctor said "You have an inflamation or a virus of some kind".

When he said "virus", I shaked.

There is some background info... I shaved my armpits without shaving foam about 3 weeks ago, just before the "episode", and applied deodorant. Could that be what "did it"? I mean, could it be localised?

Also, I am taking my HIV test on Monday, 4 weeks and 1 day after potential exposure, and I am frankly shitting myself. The test is latest generation, including p24. I realise that it's not conclusive. I will then take another test 6 weeks after exposure, once I am back home - since that test will be a latest generation one as well with p24, it should be conclusive.

The doctor here in the forum said that my exposure was very little. I can't stop thinking that the "extenuating circumstances" could possibly make me beat the odds. Since I am traveling, I have no access to counceling nor anything like that.

I will post the results for the conclusive HIV test, for everybody to see it.

Please keep your fingers crossed for me. I wonder if anybody is in fact ever gonna read this post...

[scared_aussie]

Please leave this thread open for three more weeks if possible. I'd like everybody to know that my test was indeed negative.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.

I'm not all that familiar with Australia.  But here's a link to a Perth clinic; not sure about Darwin, but I'm pretty sure there is one.  Try searching for "sexual health centre".  If not successful, call the Melbourne or Sydney SHC, where they probably can identify the best resources in either Perth or Darwin.

http://www.thehealthline.ca/cat1.asp?region=huron_perth&cid=27

HHH, MD

[scared_aussie]

Thanks a lot Doctor HHH. I think you are a saint.

For you (Doctor HHH) or for anybody else listening...

Just so that you know, I was too drunk to realise what I was doing, and didn't even realise I should have told you about my herpes... I would nornally do that, no doubt.

Also, if you or anybody looked me in the eye and asked "So, where did HIV come from?", I would answer "Well, I am the first documented patient with HIV after giving oral sex to a woman" (after checking with my wife, that is).

I read on the forum that you know Australia quite well. Well, do you have any numbers for STD clinics in Perth or Darwin? I looked and looked, but couldn't find one anywhere in the yellow or white pages (I looked for "STD clinic" and "Sexual health clinic" for quite a while yesterday and today!).

Thank you for being here. I will DEFINITELY donate more as soon as I get paid.

[H. Hunter Handsfield, M.D.]

Relax.  I'll go straight to your questions.

1) Yes, that is true.  I am unaware that anybody has ever reported or had reason to suspect HIV had been acquired by performing cunnilingus on an HIV infected woman.  Any oral exposure is low risk; you could swallow a few tablespoons of HIV infected blood and not expect to be infected.  (Many babies nursed by HIV infected mothers do not catch HIV.)  In any case, because of this, the rest of your questions are more or less irrelevant.  So very quickly:

2, 3, and 5 are variations on the same question:  Yes, yes, and no.   Your chances not only are "very good", they are certain:  you didn't catch HIV.  4) I don't know the HIV rate in Panama, in sex workers or anyone else.  6) Not at all.  You can have unprotected sex with your wife right now.  7) You cannot transmit your genital herpes by performing oral sex.  And while in general people should inform their partners of their known STDs, it probably isn't ethically necessary for commercial sex.

I don't think you need HIV testing at all.  In fact, if you were my patient and your test came back positive, my first response would be to look you in the eye and say "OK, let's talk about what other risks you have had.  Because you didn't get from the CSW in Panama."

Final comment:  Australia's sexual health centres, as they call their STD clinics, are the best system of STD/HIV clinical care and prevention advice worldwide.  If you have continuing quesions, visit the nearest one.  You can rely on their advice.

Best wishes--  HHH, MD