Another Paranoid Question

Hi Doc,

Thanks so much for this forum.  Reading it has made me feel better (unlike all the other sites) -- but not quite enough to refrain from asking a question.  I hope you don't consider this question too duplicative; I'll be seeing my partner for the first time in a while next month (we're apart for the year), and I want to make sure I don't expose her to anything, least of all HIV.

As indicated, I am a straight male in a committed relationship.  Three weeks ago, I had my first sexual experience with a guy I met via gaydar -- something I've been curious about for a while, but will never repeat.  He was in his 40s, very nebbishy, said he had not had sex for quite a while.  I asked him before we had sex whether he was negative and always played safe and he said yes.  During what turned out to be about a 20 minute encounter, I gave and received unprotected oral sex and received (for about a minute) protected anal sex with considerable lube.  He did not ejaculate in my mouth and at most I might have swallowed one drop of precum.  I didn't see any open sores or redness or anything of the sort.  The condom did not slip during anal sex, he did not ejaculate into it, and to the best of my knowledge it didn't break.

Because I have hypochondriacal tendencies, I started to worry the next day.  I asked him again if he was negative, and he assured me that he was -- "definitively."  But he wanted to hook up again, so I'm not sure if that qualifies for your general rule that people don't lie when asked directly.  I have felt fine since the encounter, other than a tiny cold that began before the event and continued after, but I can't stop checking my forehead for fever...

Should I get an HIV test for this encounter?  When I told my partner about the experience and my worries, she laughed and said I was just being paranoid.  I imagine she's right -- the guilt thing many commentators mention on this site -- but hearing it from you would make me feel much better.  And I'm most paranoid of all about the possibility of putting her at any risk.

Your response would be most appreciated.  I hope this question is "original" enough to warrant a response.  If not, you still have my thanks for the forum.

[H. Hunter Handsfield, M.D.]

On psychological grounds, get tested.  But the risk of infection is zero, for practical purposes.

You already know that the HIV risk for oral sex is low, and Brian123 has provided more details about that below.  It seems very unlikely your partner had HIV.  From a risk assessment perspective, I never recommend HIV testing because of any particular potential exposure, except in truly high-risk settings (known infected partner, anal sex with an unknown male partner, etc).

So from a strictly objective perspective, you don't need testing.  However, like most other people in your situation, it's obvious you won't be able to put this behind you unless and until you have a negative test result.  A single test 4-6 weeks after the event is sufficient.

Good luck--  HHH, MD

[Brian123]

Oral sex is a difficult means for transmission of HIV. With a number of factors that have to go awry:
(1) sufficient virus transmission from an HIV + partner
(2) You having to have an open cut/sore in your mouth
(3) the opposing partner being HIV + to start with. He said he was negative...as I would believe,...most people would not lie.
(4) lack/poor documentation showing the HIV is transmitted via oral sex
(5) Saliva being an almost natural inhibitor for HIV. The oral environment is not conducive for the HIV virus. In fact, it is not ideal at all.

Lastly, I think your lack of feeling comfortable in this kind of sexual situation is a contributing reason why you may feel uncomfortable, yet unsure.  You indeed had safe sex. For future use, I would never have unprotected oral sex, ....not because of it being considered unsafe, just out of the sake of "peace-of-mind".

The protected anal is, and was, as you stated......safe. The condom did not tear, ....and if it did....YOU would have KNOWN.

[USexpat]

My thanks to the Doc and to Brian.  I feel much better now.