Primetime

[primetimemsc]

Thanks for for your earlier response. I believe that the woman that encountered was homeless and potentially a prostitute. I did not look into her mouth to see if she had any open sores.  In addition, she was told me that she had recently had a flu or cold.  Maybe I am making too much of this, but I am scared. I realize that the oral to penis is low risk but was more concerned about the oral to anal contact. She was very aggressive and after the experience I was a little tender there. The feeling like similar to when one uses bathroom tissue that is too course. That said my doctor suggested a PEP regimen for 7 days. Any thoughts on that?

[Edward W Hook, MD]

Dr. Handsfield and I share the Forum and I started to answer your question before I realized you had just asked another question of him.  FYI, you should just ask follow-up questions as part of the same thread and do not need to start an entirely new question.  I have read Dr. Handsfield's response and will address your further concerns.  For starters, given your timing of the follow-up question, I wonder why you did not ask about PEP in your initial question- it does little good for us not to hear the entire story at once, nor does it help you.

I'll address the issue of risk first, the PEP.  I agree with all that DR. Handsfield said in his initial reply and would extend that to confirming his implied statement that oral to anal contact, like oral to penis contact, carries virtually no risk of HIV transmission and is not something for concern.  IF she was infected (still unlikely despite potentially being a commercial sex worker), there is still no evidence of oral transmission through oral-rectal contact.  I wouldn't worry.

Your followup suggests that no matter what we say however, you will be worried.  Nonetheless I would not recommend PEP.  Your risk of side effects is far, far higher than your risk of HIV.  IN addition, not only was your exposure virtually no risk but PEP's effectiveness in time limited and is recommended only if it can be started within 72 hours of exposure.  Furthermore, it you were going to take PEP, you should take it correctly, for 30 days, not 7 and that would cost you (if you have to pay for it) over $1000.00.

Hope this is helpful.  Please refer continuing question back to Dr. Handsfield as part of your original thread.  EWH

[primetimemsc]

Sorry for not replying to the first doctor. Your comments are comforting. I will get tested and keep you posted! Again thanks!

[primetimemsc]

You mentioned that the risk of PEP are greater than HIV. Why is that so?

[Edward W Hook, MD]

Dr. Handsfield is trraveling and is delayed in repsonding to you. Please be patient (it is apparent you are nto. Should you countinue to send new posts you will be banned from this and other MedHelp sites).

My statement indicated that the statistical chance of side effects for the PEP is far higher than the risk that you ahve acquired HIV from your no risk expsoure.  

EWH

[primetimemsc]

Thanks for your response. If this woman was a CSW then I would have little to no worries. However, I have learned today that this woman was homeless. In addition, the fact that she allowed me to ejaculate in her mouth seemingly suggest that I was not her first. This could be a pattern. Five days after the encounter I began to fell ill. I had a low grade fever if you can call it one (98-99). Very slight congestion. Today which in 9 days after the encounter, I have warm flashes and chills intermittently.  I am trying to stay balanced but after reading about sero conversion, I am a bit unnerved. Doc, have I allowed my mind take over reality?
Sincerely,
Scared

[Edward W Hook, MD]

As Dr. Handsfield and I have told you more than once, the exposure you describe is virtually NO RISK.  Your symptoms are not due to acute HIV.  I would urge you to seek counseling and help in working out what are inappropriate fears.  EWH

[primetimemsc]

Dr Hook,
I went to my primary care doctor and was tested Chlamydia and GCU. Both results were negative. He also ran a HIV PCR test to calm my nerves.  Now i just realized that I have a blister inside my mouth that just developed today. Is such a sore consistent with herpes or HIV? I never kissed this woman. Thanks

[Edward W Hook, MD]

Of course not. And with that this thread will end.  There will be not further answers to your anxiety-fueled questions.  You really need to get your anxiety under control.  If you cannot you should seek professional help.  EWH

[primetimemsc]

Thanks for your answers. I went to my personal physician and he administered the HIV PCR test. It was taken 11 days after my exposure. The results were negative. I realize that I was probably driving you crazy but I realized that my paranoia was probably driven by quilt among other things. The doctors on your website do a wonderful job and your analysis was "spot on" Thanks!