High Risk ?

Let me say this my doctor who is well known infection specialist told me to wait one year after exposure. So my stress level can't be any worse. I had two sexual risk in the last 3 months #1 was with a CSW unprotected oral I might had a cut but it was healing from a previous infection deepthroat was proformed and person was coughing maybe from flu or God knows what. I later had penile discharge 2 day later went to clinic got checked for gonoria and clamiydia both negative. Was given a injected antibiotic and days later discharge was gone. 3 weeks later I got tested for all STD all came back negative so me thinking I was no risk of getting HIV by oral ( mistake) I had sex with a well known friend who recently checked at 13 weeks from her last sexual partner and was negative. Recently I tested at 3 months 90 days from CSW encounter and I was negative using oralquick advance blood sample. I am having health issues included a white tongue glands on my throat and tonsilils and swelling on the tongue pretty severe were ever doctor I see are telling me we got good meds for HIV I am really scared I thought I was out the woods with 3 months from my risky encounter and thinking my friend can be infected is been 3 months she even showed me the results. I am scared out of my mind doctor just did a pcr RNA even it's been over 35 days sinse my last exposure and was negative I just need some concrete advise from somebody who knows about this I am not confident on my doctor ability even he was voted doctor of the year. Is crazy to wait a YEAR when even the CDC who is conservative only says to wait 6 months please help

[Edward W Hook, MD]

Welcome to our Forum.  I presume that though your doctor is highly respected, he is not an infectious disease specialist.  His comments about your risk are overly conservative.

First, there is no risk for HIV from giving or reeceiving 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. Some experts state there is no risk at all from 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,, oral sores and cuts, blood in their mouths etc.

Second, your doctor's estimate of when your tests will be reliable are incorrect an overly conservative.  Years ago there were a few cases of delaye bloo test positivity.  That is no longer the case.  .The traditional and most widely used tests for HIV are tests for antibodies to HIV which are available both as so-called "rapid" or point of care tests which can be done in the clinic and laboratory based antibody tests. For all practical purposes both of these types of test perform comparably and provide accurate information on the presence or absence of HIV infection in virtually everyone at 8 weeks following exposure.  The recommendations for testing at 3 and even 6 months are the result of two factors- data from older tests no longer used (you really do not need to worry about which generation of tests you were tested with, at this time virtually all tests are far more sensitive that they were even 2-3 years ago when the 3 month recommendation was made) and secondly, the fact that some, mostly governmental agencies which have to provide recommendations for virtually everyone without the sort of interactions such as those you get with your doctor or on personalized sites such as this one, feel the cannot "afford" to be wrong and therefore make recommendations and guidelines which leave most people unnecessarily nervous for 4-6 weeks longer than the 6-8 weeks it takes virtually everyone to develop HIV antibodies.  

I hope my comments are helpful to you.  EWH