A question from a 24 year old neurotic Belgian boy

[dennis24]

In Belgium the prevention organisations changed their prevention standards about oral sex a few years ago. Meaning that it is ‘possible’ hiv can be transmitted by oral sex. They changed their policy because there were big discussions about the actual oral risk. I believe that discussion is still going on?

To be short: I always practise safe sex (being a top guy) with a condom and I never give oral sex to my sexual partners and I keep my penis as far away as possible from the penis of my sexual partners. But I  recieve oral sex (me being the insertive party) unprotected. Due to a few internet stories (urban legends?) and reading several studies about the possible hiv risk by receiving unproteced oral sex I have developed an anxiety disorder and I’m now seeing a psychiatrist and will start cognitive behavioural therapy soon.

My last sexual encounter was on 22 august. I had a HIV Antibody test + HIV Antigen test (to rule out the possible window period problem) on 18 october (about 8 weeks after my last sexual encounter in august) and they were both negative. I also had a usual Antibody test + several STD tests in september and another Antibody test in the beginning of october to rule out previous sexual encounters before 22 august. They were all negative.

1.Ofcourse I keep worrying and every head ache, night sweat or cough in the last months freaks me out. I had no fevers, swollen lymph nodes, diahrea, etc. (I’m paying for my doctor’s mansion). Would you suggest another anti-body test at the end of november ((after 12 weeks, the ‘official’ window period)?

[sparkeler]

No one has debated the fact that it is "possible" to contract hiv through oral.  However, it has never been proven to be transmitted that way in people who are infected.  The risk is extremely low. The people who do test positive for HIV, most likely have had other riskier exposures.  There is a chance.  Is it likely?  No.  Should you test at the 3 month window period to compeletly erase your fears of having this disease?  Yes, only for your own peace of mind and the ability to move on.

[WorriedUS]

Dennis, see this chart from the Aids Education Global Information System:

http://ww2.aegis.org/pubs/mmwr/2005/r402a1t1.gif

Insertive Oral Sex has a 0.5/10000 chance on a per contact basis.  In other words, 0.005%.  If you round that up it is 0, numerically.  If you multiply that by 100 for like one hundred contacts with KNOWN sources of HIV, it is 0.5%.  

I think your odds of dying from a transport accident is like (one year odds) one in 6,050 click on link below.

http://www.nsc.org/lrs/statinfo/odds.htm

Take care, and get better (mentally).


-WorriedUS

[dennis24]

Hm,I thought for a 100 partners it would be 0,005 %.

But if I follow your statistical logic: I had 7 partners who givin oral sex to me. So the chance of catching HIV would be 0,035%?

[monkeyflower]

That's not the way it works. Each event carries the same statistical risk, which in this case is purely hypothetical. Let it go.

[WorriedUS]

Dennis,

you're right. I had a typo..the statistical probability for any one event: is .5/10,000 = .00005 which translates into a .005%.

But monkeyflower is right as well. You don't multiply the events to ascertain their joint probability; that's when you want the probability of more than one outcome (like having HIV AND Herpes..etc.) .  The risk is not cumulative, it is the same for each event/contact.

-WorriedUS

[dennis24]

Okay, so the conclusion is:

for 7 partners the statiscal risk for the insertive oral partner (me) is 0,035 %? (0,005 % x 7 partners = 0,035 %).

If I'm wrong could you do the risk calculation for please?

Thanks

[WorriedUS]

dennis24

yep, you're right.  the statistical probability for any single outcome is called an OR which mathematically turns into a plus sign, from my understanding.

so yes, for e.g., if you had unprotected sex with 7 HIV POSITIVE partners for SURE, with the risk being the same every time, the cumulative risk would mean something. like 1/2000 is a single-exposure risk for vaginal intercourse, so 7/2000 would be your cumulative risk. that's how Magic Johnson probably got it, cuz he had sex with thousands of women, so somewhere in those thousands, he received the virus, i.e., his risk became cumulative enough for him to get it.

But you can't split hairs that way, okay?  The doctor HAS mentioned that someone's risk might indeed be 1/2000, but conversely, the risk could be much higher or much lower.  These are just average numbers from the table from AEGIS, and are pooled from very LARGE numbers of patients over a long period of time.  Doc H has mentioned that he sometimes sees risk among his clinic's patients that are much higher than that of the table.

Also, I'm sure that the risk from a cumulative standpoint is not exactly linear, if you were to graph it. Just because you have had sex with 2000 people of KNOWH HIV POSITIVE status, doesn't mean that you WILL get HIV.  Although the risk is cumulative over time, you could theoretically never get it.  

The Virus was just discovered ~25 years ago, so there hasn't been that many studies that focus on cumulative risk as a linear progression.  

Bottom line, STOP worrying.  We're all on here because of our anxiety and limited understanding of the risk for transmission for our specific sexual behaviors.  You already had a single antibody test at 8 weeks.  THAT IS DEFINITIVE. Doctor H would tell you any test beyond the 6-8 week period (if the test was necessary at all) is UNNECESSARY and that if you CANNOT get over why you are still having symptoms, then you NEED mental counseling.

Symptoms are NEVER EVER a definitive sign of HIV infection. Test results ARE!!!!  No doctor will ever say 100% you have HIV from your symptoms NEVER EVER EVER EVER!! IF he/she does, they deserve to have their license taken away.  ONLY test results tell you if you are infected.

And you clearly were NOT. So please relax. Go see a therapist.  You are obviouslyl suffering from paranoia, at some level.

-WorriedUS

[dennis24]

Okay, thx very much but can you clarify this:

"Doc H has mentioned that he sometimes sees risk among his clinic's patients that are much higher than that of the table."

What do you mean by that? That from the experience of Doc H the risks are higher then the AEGIS Tables. For example: 0,5/10000 could actually be 2/10000?

[WorriedUS]

Can't vouch for numbers, but yes, some risks can be higher. Like I know he says unprotected receptive anal is VERY high with a known HIV person, but most experts will tell you the same thing.  Like in the table, it says receptive anal is is 50/10000=.5%, but in Dr. H's clinic he has a much lower risk assessment of 1/500 =.2%, almost twice the number lower.  But the table is more accurate I think because it covers a LOT more people.

But now you're splitting hairs!