HIV Transmission Risk?

[overreacting]

Hi Doctor,  Your forum has really helped put me at ease to a certain degree, however I wanted to ask you about my specific question.

I had a few exposures that I am worried about.  I have had protected vaginal/oral sex with 6-7 sex workers (All in Canada - Escort Services) over the last year (something I really regret now and will never do again)  All instances were with a condom, with no noticeable breakages.  The last occurance was in June of this year where I also performed unprotected oral sex on this sex worker.  I didn't think anything of it, until I read that oral sex was a possible transmitter of HIV.   Approxiamately 8.5 - 9 weeks after this exposure I had a 5 day bout with Diarrhea, and automatically assumed it was due to ARS. I had no noticeable fever, no swolen lymph nodes, or anything else that I can really remember.  (I may have had a sore throat but I cannot really remmeber)

So my questions are:

1) What risk do you think I have put myself in?
2) Do you think ARS could start 8.5 weeks after initial infection?
3) Would my symptoms indicate ARS?
4) Would you recommend me getting tested?

I am worried sick.  Thanks DR.

[H. Hunter Handsfield, M.D.]

scared_aussie already responded accurately (below).  You have no cause to be "worried sick".  You read wrong; oral sex is not an appreciable risk for HIV.  Briefly:  1) You had safe sex and have no HIV/STD worries.  2) No, that's too long.  3) No. Symptoms virtually never are a useful indicator of whether or not someone has acquired a new HIV infection, no matter how tyical they are.  (And yours aren't typical anyway.)   4) No.

You don't say why you "regret" the sexual events you describe.  Perhaps infidelity to another partner, or maybe you are morally conflicted about commercial sex.  From a health standpoint there is no cause for regret.  

HHH, MD

[scared_aussie]

I am not a doctor. However, this question has been asked before - last time by myself!
Here is a link to Dr. H's answer to my question:

http://www.medhelp.org/perl6/HIV/messages/372.html

I can only forecast what the doctor will tell you. Please remember to wait for Dr. H's answer - I am just a normal user, who happened to have a very similar question and a very similar problem.

1) Your exposure of unprotected oral sex carries a negligible infection risk.
2) Symptoms don't mean anything. ARS typically starts 2-4 weeks after exposure. Symtoms normally come at the same time - and leave at the same time
3) Symptoms don't mean anything at all, as they can be caused by 100000 different things.
4) Test for your peace of mind. Since it was more than six weeks ago, your test will be conclusive and you will be able to put all this behind you.

I hope this helps. Again, wait for Dr.H's answer, which will be more informed. I only did an intensive corse on being worried sick about oral sex, rather than a full degree in medicine.

[overreacting]

Thanks for the quick reply DR.  To answer your question about regret, it was due to infidelity.  The Diarrhea that I had just scared me, and had me worried about passing something on.

I know that symptoms are not conclusive when it comes to HIV, however I was just curious why my symptoms were not like ARS?  Is it because of the length of time of the symptom, (5 days) or was it because it was not accompanied by anything else??  

And my last question, I promise not to fill this forum with what ifs. I just had a question about condom use.  When they say condoms are 95% percent effective in the prevention of HIV, does that mean that the 5% that are not effective are due to Condom Breakage or slippage?

Thanks so much, and I promise not to ask more questions on this topic.

[H. Hunter Handsfield, M.D.]

Pretty much everything you described is atypical for ARS.  Delayed onset; lack of fever, which is almost always present in ARS; no lymph node enlargement; only 5 day duration; and diarrhea is not a common symptom of ARS.

A properly used condom that doesn't break is 100% effective in preventing HIV transmission.  The 95% figure is on a broad, population basis--that is, it takes improper use into account.

HHH, MD

[anxietyX5]

Hi, I have heard that stress can bring on symptoms in some people. When you freak yourself out it's almost like you are trying to find symptoms in yourself, and it seems to be that you will almost always find something that really isn't there. I have also done something really stupid, I slept with someone that I didn't even know, of course "unprotected",but he did pull out I have been freaking out for the past 12 weeks. I was tested last week at 11 weeks using the oraquick advance and was thankfully negative. But I have noticed small pink dots a quarter inch wide, and I don't know what they are. Does anyone know if the oraquick advance is just as accurate at detecting early positives as any other test?

[overreacting]

Does everyone agree that giving unprotected Oral sex to a woman is not a risk at all?

There is just so much information on the internet which gives a different perspective.  

I was just curious what everyone's opinion (Including Dr HHH) on thi matter is.  

Thanks everyone!