Risk Asessment

Protected vaginal sex with CSW several times. Unprotected oral from another CSW twice. Do I have a risk and should I be tested.

Does ARS always have a high fever associated with it?

Have you seen anyone develop HIV from consistent use of condoms?

[Edward W Hook, MD]

No risk and no medical reason for testing.  Remember, odds are that your partner did not have HIV.  While HIV is more common in CSWs than others, it is still rare.  In addition, your genital sex was condom protected and, in the unlikely circumstance that she did have HIV, your risk of getting infected with condom protected genital sex is less than 1 in 100,000.  

As far as oral sex is concerned, the quoted figure for HIV risk, if one has unprotected oral sex from 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, etc.

ARS typically does have a fever associated with it, among other symptoms however the symptoms of the ARS are TOTALLY non-specific and when people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes. In contrast, over a given year, there is almost no one who has not had a viral illness, night sweats or both (sometimes on multiple occasions).  In addition, it is also important to realize that many persons who acquire HIV do not experience the ARS.  For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.

No, personally, I have never seen someone get HIV while consistently using condoms.

Bottom line, as I said before, no risk and no medical indication for testing.  EWH

[Maxfli2]

Thank you for the prompt reply. My final comment is in regards to symptoms associated with this exposure. I've been experiencing headache, sore throat, muscle ache, and what feels like painful lymph nodes in various area's of my body, for 10 days starting 2 weeks from ny last exposure..

I have read synptoms are not a  reliable indicator of infection. Would you still not recommend testing to rule out even the remote posibility of infection based on the symptomology.

Thanks for providing this service to the countless thousands of anxious people who visit this site.

[Edward W Hook, MD]

Symptoms have been proven to be worthless as an indicator of HIV infection.  If you choose to get tested, please do so acknowledging that you are doing so for your peace of mind, not for symptoms.  then believe the result.  EWH