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HIV Prevention (Expert Forum)
Driving Myself Crazy with Guilt and Fear
Answered by
Edward W Hook, MD - HIV Prevention, stds
Driving Myself Crazy with Guilt and Fear
by concerned2008581, Mar 22, 2009 01:58PM
Hi Dr. Thanks in advance for your help.
About a week ago I went to a strip club, got drunk and took back to the room a stripper. I was really drunk and don't remember everything, but I know I performed unprotected oral sex on her. When I woke up, there was a condom wrapper on the night stand. I talked to the girl the next day and she assured me that I wore a condom and that she had been just tested for STDs and was clean and I had nothing to worry about.
Since I am married and this is a first for me, of course I am feeling very guilty and very scared and am convinced I caught an STD, particularly HIV, and that my life is over. I am having a hard time concentrating and my wife is wondering what is wrong with me.
With all the factors listed above, what are my chances I caught an STD, in particular HIV?
Secondly, should I be tested, and if so when? After 7 days, can all STDs be tested for except HIV?
Thirdly, I heard that there is an HIV test that you can take a few days after potential exposure that is very accurate... do you know if that is true and where I can take that test?
Scared to Death!
Doctor's Answer
by Edward W Hook, MD, Mar 22, 2009 05:11PM
, Mar 22, 2009 05:11PM
Your risk of HIV and other STDs is low. Your major exposure was unprotected oral sex since a condom was used for vaginal sex. Here are the facts:
1. Your partner said she was clean. She was probably telling the truth, most people do.
2. Your genital sex was condom protected and therefore no risk.
3. HIV is rarely, if ever transmitted through oral sex. The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Other experts state there is NO risk form oral sex. Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex. This includes by all of the people who had gum disease, etc.
4. For other STDs, oral sex is an inefficient way to transmit STDs. Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny. If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection). Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.
In your case, you had a single exposure. I would urge you not to worry. If you wish, you could go to your local STD clinic or health care provider to be tested at this time. The results of testing for bacterial STDs will be reliable.
For HIV testing, we would suggest that you get a test at 4-6 weeks after your exposure. In your situation, when the test result is negative, you should take the result as proof that you did not get HIV from your encounter. Some people suggest getting a PCR test for more rapid results. While theoretically appealing, these expensive tests are not recommended for routine HIV testing.
Hope these comments help. EWH
1. Your partner said she was clean. She was probably telling the truth, most people do.
2. Your genital sex was condom protected and therefore no risk.
3. HIV is rarely, if ever transmitted through oral sex. The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Other experts state there is NO risk form oral sex. Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex. This includes by all of the people who had gum disease, etc.
4. For other STDs, oral sex is an inefficient way to transmit STDs. Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny. If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection). Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.
In your case, you had a single exposure. I would urge you not to worry. If you wish, you could go to your local STD clinic or health care provider to be tested at this time. The results of testing for bacterial STDs will be reliable.
For HIV testing, we would suggest that you get a test at 4-6 weeks after your exposure. In your situation, when the test result is negative, you should take the result as proof that you did not get HIV from your encounter. Some people suggest getting a PCR test for more rapid results. While theoretically appealing, these expensive tests are not recommended for routine HIV testing.
Hope these comments help. EWH
