Transmission risks

A week ago I had unprotected oral sex with a prostitute. We did not have genital sex (protected or otherwise) all I had preformed on me was fellatio. She allowed me to cum in her mouth. She told me she had a new lip ring placed in her earlier that day, as well as telling me that the previous night she was drunk and may or may not have had unprotected sex with some one she met at a bar.
Four days later I had to leave work early as I had diarrhea and dry heaving ( I would have vomited but had nothing in my stomach) I also had fever and sweating. This lasted for about a day or so. Now when I looked up her internet profile today it said she was also sick just after our encounter, this begs the question what are the odds of contracting hiv through unprotected oral sex as a receiver. For arguments sake if she had just contracted it, how contagious would she be if just recently infected?  Would this virus appear this quickly after exposure as opposed to the 2-3 weeks that most other research on the internet suggests. What type of tests could I get that would be the most accurate with out having to wait 90 days to get tested? Any other additional information you have would also be appreciated.

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.  I wonder if you followed the advice in the Disclaimer message, asking users to look at other similar questions. Yours are among the most common on this forum. The replies are always the same.  Here they are again:  

You were not any measurable risk for HIV.  There is a long list of reasons you should not be worried about this event.  Assuming you are in the US or other industrialized country, it is unlikely (probably around 1 chance in 1,000) your partner had HIV.  Oral sex is zero to low risk; some experts believe HIV is never transmitted from an oral to genital partner by oral sex, and the maximum estimated risk is 1 chance in 20,000 (which is equivalent to receiving oral sex by HIV infected people once daily for 55 years and maybe never getting infected).  Symptoms never are useful indicators of new HIV infection, even they they are typical fo acute infection -- because the identical symptoms are caused by many other infections that are far more common.  In any case, your symptoms don't sound like HIV, which doesnt cause gastrointestinal symptoms like nausea and diarrhea.  Finally, HIV cannot cause symptoms in under 7-10 days.  It is impossible that HIV would cause your illness starting 4 days later.

Based on your exposure history and symptoms, you really don't need HIV testing at all.  The main reason for testing is for anxiety relief from the negative result.  So if my reassurance doesn't calm your fears, have a standard HIV antibody test in 6-8 weeks.  You can expect negative resutls.

As for 3 months (90 days), that's old news.  With modern tests it is rarely necessary to wait that long, unless the exposure risk is especially high.  However, it is true that many agencies continue to recommend testing at that time -- so feel free to have an additional test at 3 months if you feel like it.

In the meantime, mellow out.  There is no realistic chance you caught HIV.  Before you ask any follow-up "yes but", "what if", or "did you really mean" questions, please spend at least an hour reading other threads on this forum -- knowing for sure that anything else you ask will have the same replies as all the others.

Best wishes--  HHH, MD