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Concerned about HIV transmission
I am concerned over a recent sexual encounter. I posted in the community forum but am looking for more expert opinion.
I was perusing through listings on the website "backpage" and came across women offering their services. I found one who was willing to be with me for very cheap (60 bucks). She came over, took off her clothes, and got in bed. Since she didnt take out a condom, I suspected she was going to start with a handjob and I asked if she had any "lube". She said "not necessary" as she is "naturally lubricated". She pulled me onto her and we started having vaginal, unprotected sex. I couldnt believe I was doing this (ie without a condom). After about 5-10 minutes of sex, I pulled out and ejaculated (ie did not ejaculate inside her).
Afterwards, I asked her why she had unprotected sex with me and she said, "I guess I just didnt come over fully prepared". It seemed like a strange answer. I asked her if she gets tested for STDs and she says that she does and has never tested positive in the past. However, she seemed a bit suspicious and her "reassurance" was not too reassuring.
It is now exactly 8 days following that encounter and I have the rather sudden onset of a bad sore throat. In fact, I have even "lost my voice" (sort of like a painful laryngitis). I do not think I have a fever. I do have a mild headache and am feeling fairly fatigued. Can you please provide me with your general thoughts about the incident I describe but also try to answer these specific questions:
1. My risk of HIV
2. Whether not ejaculating inside her vagina lessens the transmission risk
3. Whether I should or shouldnt get tested
4. Whether my symptoms could be consistent with acute HIV and how does acute HIV typically present itself (ie symptoms, time course, do all the symptoms occur at once, etc).
I am scared and regretful. I wish I didnt do what I did.
Thank you very much for your time reading and answering my question(s). Very much appreciated.
I was perusing through listings on the website "backpage" and came across women offering their services. I found one who was willing to be with me for very cheap (60 bucks). She came over, took off her clothes, and got in bed. Since she didnt take out a condom, I suspected she was going to start with a handjob and I asked if she had any "lube". She said "not necessary" as she is "naturally lubricated". She pulled me onto her and we started having vaginal, unprotected sex. I couldnt believe I was doing this (ie without a condom). After about 5-10 minutes of sex, I pulled out and ejaculated (ie did not ejaculate inside her).
Afterwards, I asked her why she had unprotected sex with me and she said, "I guess I just didnt come over fully prepared". It seemed like a strange answer. I asked her if she gets tested for STDs and she says that she does and has never tested positive in the past. However, she seemed a bit suspicious and her "reassurance" was not too reassuring.
It is now exactly 8 days following that encounter and I have the rather sudden onset of a bad sore throat. In fact, I have even "lost my voice" (sort of like a painful laryngitis). I do not think I have a fever. I do have a mild headache and am feeling fairly fatigued. Can you please provide me with your general thoughts about the incident I describe but also try to answer these specific questions:
1. My risk of HIV
2. Whether not ejaculating inside her vagina lessens the transmission risk
3. Whether I should or shouldnt get tested
4. Whether my symptoms could be consistent with acute HIV and how does acute HIV typically present itself (ie symptoms, time course, do all the symptoms occur at once, etc).
I am scared and regretful. I wish I didnt do what I did.
Thank you very much for your time reading and answering my question(s). Very much appreciated.
MEDICAL PROFESSIONAL
Welcome to the forum. Bottom line: I agree with the responses you had on the community forum. You are at very low risk for HIV.
As to the multiple protected oral exposures with escorts you described in April: I agree no risk and no need for HIV testing.
The recent unprotected vaginal sex episode in theory could be risky. I agree your partner's behavior is a bit bizarre and that she could be ar risk. But your behavior seems peculiar as well. The choice to not use a condom was as much yours as hers! However, it is the rare sexually active woman in the US, even those with multiple partners, who has HIV -- probable average chance 1 in 1,000. Actually lower in this case, since people generally don't lie about HIV or STD status when asked directly. Further, even if she had HIV, the average transmission risk is about 1 in 2,000 for each unprotected vaginal sex event. So from those statistics together, your risk of having caught HIV is somehwere around 1/1000 x 1/2000, or 1 chance in 2 million. That is, virtually zero.
I doubt your sore throat has anything to do with the sexual encounter. Or maybe you caught a garden variety respiratory virus from her. In any case, I have never heard of HIV causing laryngitis, and absence of fever is additional evidence against a new HIV infection.
To your questions:
1) Answered above.
2) There is no difference in HIV risk for men with or without ejaculation. By not ejaculating in her, you reduced her risk of HIV or other STDs from you, but not the other way around.
3) From a risk standpoint or your symptoms, you do not need HIV testing. However, if my words don't settle your fears about it, you could have an HIV antibody test 6-8 weeks after the event, or a combo test (HIV antibody plus p24 antigen), which gives definitive results at 4 weeks. (This is not code to suggest I really believe there was a significant risk of HIV. I do not. I suggest testing only if you need the negative result for reassurance.)
4) As noted above, your symptoms do not suggest HIV. The most common symptoms of acute HIV are sore throat, fever (over 101), and a body-wide measles-like skin rash; 70% of people have all three. They pretty much come on at the same time, typically 10-14 days after exposure. For more detail than that, I suggest you go online or search this forum for other discussions.
Bottom line: Mellow out. Almost nobody HIV heterosexually from a single, one-off exposure. In the 7 years of this forum, not one person has turned out to catch HIV from an exposure they asked about. You aren't going to be the first.
Oh, and buy some condoms and keep them handy!
Regards-- HHH, MD
As to the multiple protected oral exposures with escorts you described in April: I agree no risk and no need for HIV testing.
The recent unprotected vaginal sex episode in theory could be risky. I agree your partner's behavior is a bit bizarre and that she could be ar risk. But your behavior seems peculiar as well. The choice to not use a condom was as much yours as hers! However, it is the rare sexually active woman in the US, even those with multiple partners, who has HIV -- probable average chance 1 in 1,000. Actually lower in this case, since people generally don't lie about HIV or STD status when asked directly. Further, even if she had HIV, the average transmission risk is about 1 in 2,000 for each unprotected vaginal sex event. So from those statistics together, your risk of having caught HIV is somehwere around 1/1000 x 1/2000, or 1 chance in 2 million. That is, virtually zero.
I doubt your sore throat has anything to do with the sexual encounter. Or maybe you caught a garden variety respiratory virus from her. In any case, I have never heard of HIV causing laryngitis, and absence of fever is additional evidence against a new HIV infection.
To your questions:
1) Answered above.
2) There is no difference in HIV risk for men with or without ejaculation. By not ejaculating in her, you reduced her risk of HIV or other STDs from you, but not the other way around.
3) From a risk standpoint or your symptoms, you do not need HIV testing. However, if my words don't settle your fears about it, you could have an HIV antibody test 6-8 weeks after the event, or a combo test (HIV antibody plus p24 antigen), which gives definitive results at 4 weeks. (This is not code to suggest I really believe there was a significant risk of HIV. I do not. I suggest testing only if you need the negative result for reassurance.)
4) As noted above, your symptoms do not suggest HIV. The most common symptoms of acute HIV are sore throat, fever (over 101), and a body-wide measles-like skin rash; 70% of people have all three. They pretty much come on at the same time, typically 10-14 days after exposure. For more detail than that, I suggest you go online or search this forum for other discussions.
Bottom line: Mellow out. Almost nobody HIV heterosexually from a single, one-off exposure. In the 7 years of this forum, not one person has turned out to catch HIV from an exposure they asked about. You aren't going to be the first.
Oh, and buy some condoms and keep them handy!
Regards-- HHH, MD
MEDICAL PROFESSIONAL
1) This forum, and the bulk of HIV/STD prevention experts, never recommend HIV testing in response to individual exposures, unless particularly high risk -- e.g. unprotected sex with a known-infected partner. The risk after any individual exposure simply is too low. Instead, it is better for non-monogamous sexually active persons to just plan on regular testing, e.g. every 1-3 years. But as I told you, it is always an option to be tested for the psychological benefit, i.e. reassurance.
2) The answers to all these questions are as you would expect from my reply above: there is simply no realistic likelihood your symptoms are due to HIV. You caught a cold, nothing more -- only a coincidence with your sexual exposure. If you think objectively, you will understand it: every year millions of people in the US get colds but only a few thousand catch HIV. (Almost all of those are in people at far higher risk than you.) Many of those with colds happen to have had new sexual exposures about the same time, merely by coincidence.
Don't over think this situation. Re-read my closing comment above. Suck it up and move on. That will be all for this trhead.
2) The answers to all these questions are as you would expect from my reply above: there is simply no realistic likelihood your symptoms are due to HIV. You caught a cold, nothing more -- only a coincidence with your sexual exposure. If you think objectively, you will understand it: every year millions of people in the US get colds but only a few thousand catch HIV. (Almost all of those are in people at far higher risk than you.) Many of those with colds happen to have had new sexual exposures about the same time, merely by coincidence.
Don't over think this situation. Re-read my closing comment above. Suck it up and move on. That will be all for this trhead.
Thank you very much for your thoughtful reply. Your reassurance helps a tremendous amount. I actually do not want to get tested if you do not think I need to so I am relieved to hear that you feel that way.
However, can I please follow up with just a few more questions to give me some final peace of mind?
1. Can you elaborate a bit more in terms of why you do not recommend testing for me. In other words, what is it about the encounter I describe that you think makes my risk so exceedingly low that you do not think I should get tested? Asked a different way, what is your general threshold to recommend testing? (short of simply reassuring the subject that he/she indeed does not have HIV like you suggested).
2. Regarding my possible ARS symptoms, just to clarify, I clearly have a sore throat (began in the morning and at work, it progressed to "laryngitis-like" I think in part because my job forces me to talk a lot and by the end of the day I had almost lost my voice). I also feel more fatigued than usual, have had an intermittent headache, and today have developed diarrhea. On the other hand, as you state, I do not think i have had a fever (though I have not measured my temperature) and I do not have a rash.
-a.Can my symptoms at all be consistent with ARS without the obvious fever/rash?
-b.Have you ever heard of ARS symptoms that also include mild "cold" like symptoms (ie I have VERY MILD post-nasal drip but no other typical common cold symptoms) accompanying the sore throat, etc.
-c.Do you feel that ARS symptoms typically occur more commonly 10-14 days after the exposure as opposed to the 2-4 weeks after that I have read other places? In other words, I was trying to reassure myself that because my symptoms have started approximately 8-9 days after the exposure that perhaps this was too early?
-d.Finally, do people with ARS symptoms feel quite sick? In other words, I dont feel too well (ie my sore throat, fatigue, etc) but I dont feel TERRIBLE (ie I have had the flu before and couldnt get out of bed for two days and that is not the case right now).
I apologize for the repeat set of questions but your first reply was so helpful and I just needed to get these off my chest once more. Thank you again!!
However, can I please follow up with just a few more questions to give me some final peace of mind?
1. Can you elaborate a bit more in terms of why you do not recommend testing for me. In other words, what is it about the encounter I describe that you think makes my risk so exceedingly low that you do not think I should get tested? Asked a different way, what is your general threshold to recommend testing? (short of simply reassuring the subject that he/she indeed does not have HIV like you suggested).
2. Regarding my possible ARS symptoms, just to clarify, I clearly have a sore throat (began in the morning and at work, it progressed to "laryngitis-like" I think in part because my job forces me to talk a lot and by the end of the day I had almost lost my voice). I also feel more fatigued than usual, have had an intermittent headache, and today have developed diarrhea. On the other hand, as you state, I do not think i have had a fever (though I have not measured my temperature) and I do not have a rash.
-a.Can my symptoms at all be consistent with ARS without the obvious fever/rash?
-b.Have you ever heard of ARS symptoms that also include mild "cold" like symptoms (ie I have VERY MILD post-nasal drip but no other typical common cold symptoms) accompanying the sore throat, etc.
-c.Do you feel that ARS symptoms typically occur more commonly 10-14 days after the exposure as opposed to the 2-4 weeks after that I have read other places? In other words, I was trying to reassure myself that because my symptoms have started approximately 8-9 days after the exposure that perhaps this was too early?
-d.Finally, do people with ARS symptoms feel quite sick? In other words, I dont feel too well (ie my sore throat, fatigue, etc) but I dont feel TERRIBLE (ie I have had the flu before and couldnt get out of bed for two days and that is not the case right now).
I apologize for the repeat set of questions but your first reply was so helpful and I just needed to get these off my chest once more. Thank you again!!
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