Should I retest? (Oral and kiss with visible blood after)

[Nicky Smith]

5 weeks prior to testing (I was negative) I gave oral sex to a man I was dating (and thought I was falling for)- though he said he had been safe, now I realize I had not asked him if he had tested- and quite frankly I do not take his word for it.
3 weeks prior to testing we had been kissing. Trying not to crush his dog who had jumped right next to me, I bit his lip- he was bleeding (visible blood on his lip) and I tasted blood. We stopped kissing.
My question: should I test again? I know his chances for having HIV was low to begin with, but just in case, I had read about a case where someone had gotten HIV from kissing- I know I do not have bleeding gums but I am worried anyhow- especially with conflicting info on the risks of anything oral- I feel somewhat relieved about the oral sex incident (which did involve swallowing) as it was 5 weeks before I tested, but the kiss with blood was only 3 weeks prior to testing- should I test again and if so, what are my risks?
                        I am very anxious!

[WorriedUS]

Doc, here is that case that was reported from a possible kissing case after the guy brushed his teeth (his gums were bleeding) and his gf kissed him during sex.

Here is that old story:

http://www.aegis.com/news/re/1997/re970708.html

But the silver lining, up until that time, the article mentions of the 500,000 AIDS cases, none had been reported by kissing.  I hope that gives you some solace Nikki.

For my own peace of mind I would def. get tested, but you'll almost surely be neg. if that was your ONLY incident.  If you were positive, the Doc would say, "Let's talk about your case, because you almost surely didn't get HIV during this last incident of oral".  The risk is just TOO slim.

see this table from the Aids Education Global Information System and the following link from TheBody.com that has a beautiful post answered by Dr. Frascino, an HIV+ gay doctor who quells commonly held misconceptions about oral sex.

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

http://www.thebody.com/Forums/AIDS/SafeSex/Current/Q174878.html


it'll help calm your fears of Oral sex.

regards

-WorriedUS

[sparkeler]

There is such a small risk acquiring hiv through oral sex, that he wouldn't advise testing, especially if that was your only real exposure.  If you can't convince yourself otherwise and feel you need to test for your own sanity, then by all means do it.  It will be negative.

[Nicky Smith]

I can see your point about the kissing- however you did not address my other question: if you have aknowledged that there is a risk GIVING oral sex (with ejaculation) then why did you write that testing was not necessary?
Additionally, as you have advised people on this board to test at 6 weeks, and I tested at 5 weeks, should I not consider the 5 weeks period reliable and retest?
Thanks for responding!

[H. Hunter Handsfield, M.D.]

Not knowing the source or reliability of the "documented case" you read about, I cannot say for sure whether or not transmission by kissing occurred.  But I still doubt it.  Most people with HIV don't know which of many possible exposures actually resulted in transmission; others don't realize they are at risk from more traditional sources (e.g., not knowing a spouse has HIV); and others simply lie because they don't want to reveal embarrassing or incriminating information (infidelity, drug use, etc).  An infected person's statement that s/he acquired HIV that way is extremely unreliable.

Also, the very fact that someone decided to report such a case proves the point of how rare it is.  If it occurred all the time, nobody would bother to report it.  And even it it was real, if only one case has been reported, in the millions of HIV infections worldwide in over 25 years, what does that tell you about the odds?

Put things in perspective.  If you're going to worry about this level of risk, then I have to assume you never drive, don't go out in the rain (lightning), and never take commercial flights--all of which bring higher risk of killing you than getting HIV by kissing.

HHH, MD

[Nicky Smith]

I am heeding your advice about counseling. However, I did read a documented case where it was probable a woman did indeed get HIV from kissing- assuming if that was the way she acquired it, it upped my anxiousness because it is possible- I understand your rationale about statistics- but don't you ever take the motto "better safe than sorry"- if something is possible, shouldn't you test, even if the chance is very low? And why did you say I should not have tested, if there have been documented cases of people who perform oral acquiring it?
Thank you very much- though I do not fully understand why you think I am in the clear (I am writing again hoping that I WILL understand), your advice has made me feel a lot better.

[H. Hunter Handsfield, M.D.]

There was no chance of HIV from the exposure you described.  You are right you didn't need testing to begin with, and the kissing episode doesn't change that.  Nobody in the world ever is known to have acquired HIV by kissing, blood or no blood.

You clearly have an inflated sense of HIV risks.  Do some reading.  And if you remain irrationally anxious, seek counseling.  If you're going to get this nervous about virtually zero risk sexual encounters, what are you going to do if/when you have vaginal sex with new partners?

HHH, MD