Unique possible exposure to HIV in Asia. Very scared...

Hello doctor, I am currently living with unbearable anxiety and fear from a possible HIV infection.  Me and my friends went to Japan this summer and we, being intoxicated and happy, went to this

[H. Hunter Handsfield, M.D.]

First, your exposure was zero risk for HIV, regardless of missing teeth or residual presence of other men's semen.  (And despite the title of your question, your exposure is not at all "unique"--it's just like all the hundreds of others about receiving oral sex.  In all the years and billions of blow-jobs that occurred since HIV appeared in the world, there have very few (if any!) HIV infections transmitted that way.  On top of all that, my understanding is that HIV is not common in Japanese commercial sex workers.

And your 7 week test proves you were not infected. Period, full sotp.  All the other information you describe about symptoms etc is irrelevant:  it is proved you did not catch HIV.  So the answers to your questions are 1) Zero.  2) Totally conclusive.  3) Zero.

Bottom line:  Relax.  Oral sex is safe sex.

[yoy]

The doc will tell you that the neg. resutl at 7 weeks is reliable.  6 weeks is his standard answer-  If you want reassurance get another test-

He will most likely tell you that the risk is small-

Oral sex carries a slight risk(no reported/documented cases of such transmission)- If you assume an infected prior patron let behind some virus- you have to have a sufficiently high viral load to create an infection, the would need to enter you- the propensity of saliva to stop infection would need to have not helped out here- there are just too many variables to say this changes the whole equation.

If you want odds- unprotected vaginal sex is a 1-1000 chance-if this is comparable go with that-

But the test is what is important- if it says no the answer is no- re-test if you need to put it behind you.

[WorriedUS]

ST,

You said the following:

"I went for a rapid oral HIV test after 7 weeks since the incident and it came out Negative."

The doc would stop reading your situation after you told him that INVALUABLE piece of information.  Most experts who are HIV specialists (will tell you a single HIV antibody (most of which are 4 generation) test at 6-8 weeks is ALL that is needed (including Doctor Handsfield).  Many government and private organizations have a standard issued policy of saying 3 months is the norm to test for HIV, but that is because they have other CYA (cover your ***) reasons for saying so.  But point being, YOU DO NOT HAVE HIV.

But going a step before that, I believe the doctor would assess your risk as virtually NILL from receiving (insertive) oral sex. You should look at the most recent post since yours (in the STD forum) today titled "Herpes? Skin Infection? What??" by NeverRacked which has a situation for RECEIVING oral sex . Doc H responded by saying oral sex has a VERY low risk.  But I'll repaste it for you here.

And in case you are still nerve wracked, let me just direct your attention to this table (link pasted here) by the Aids Education Global Information System (well-reknowned) which explains that the risk for oral sex on a per contact basis is 0.5/10,000 = .005 percent.  I.e., near 0.


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

You'll see from this table that the risk of performing oral sex (is also quite low, lower by 10X of penile-vaginal sex) without a condom, ON an HIV + person!! so from a risk standpoint, I wouldn't think you would need testing except to allay your anxiety.

Also, here is ANOTHER great link that is to TheBody.com website, a website/organization run by an HIV+ doctor who also answers questions and situations for people who feel they may have engaged in possible "risky" behaovior.  Oral sex used to be a forum that was highly used, but because of its low risk nature and repeat situations, the topic of Oral Sex and its risks for HIV infection was discontinued. But prior to that, Dr. Frascino (an HIV specialist), answers beautifully and rather wittily a post by a forum user regarding the "perils" of both performing (insertive) and receiving oral sex.  Check it out. If the link doesn't work for you, let me know, and I'll copy the text in this thread for you.  

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


Also, you should type in "Oral Sex HIV" into the search engine of this site and see all the great posts regarding the risk of receiving (insertive) oral sex.  

That other thread off medhelp.org (the site you are on) is reposted below.  Good luck.:

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sclb01
11/01/2006

Hi Doctor,

First, I wanted to thank you for this site. I think it helps many people, and I know that it's something I've referenced on repeated occassions, mostly as a reality check.

Anyway, here's my story. I'm a 29 year old man, and recently I received oral sex from someone that I didn't know at all. Not my finest moment, but I understand that the risk of acquiring an STD from such behavior is extremely low. From looking around your site, it seems that this breakdown of risks for various diseases is as follows - I realize that this information is available elsewhere, but I hadn't found it compiled in one place:

Herpes - I had cold sores as a kid, meaning I carry HSV-1. Therefore, there's no way I can reaquire it from any form of sexual contact. I have no risk for HSV-2, as it is impossible to acquire through receptive oral sex.

HSV - Again, no risk.

HIV - Little or no risk. On other sites, I've seen claims of cases where HIV was transmitted this way, but it doesn't seem that such reports have a lot of credibility in the medical community.

Chlamydia - No risk of oral transmission.

Gonnorehea and NGU - Here, there actually is a risk of transmission in my case, although considerably lower than unprotected vaginal sex. To be completely safe, I should probably get tested (though this only happened a couple of days ago, I believe that a test given today would be accurate).

Syphillis (syphilis), etc. - Other than the above (with HSV-1 being the primary risk for non-carriers), STDs can't be transmitted by receiving orsl sex.

Again, thanks for your time. I realize that I'm repeating a lot of information here, but laying out all of my risks makes me feel better.


Forum-M.D.-HHH
11/01/2006

sclb01 I don't see a question in there, unless you would like affirmation that you have correctly interpreted the information you found by browsing the site. You have. To summarize, although there is a slight risk of HIV, gonorrhea, HSV-1, and NGU due to oral bacteria, in general oral sex is highly safe--much less likely to result in STD than either vaginal or anal sex.

Good luck-- HHH, MD

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Doc, sorry to repaste this one, just tryin to help you out as we all know you are busy and that oral sex questions are constantly repeated.

[WorriedUS]

ST,

Here's one more thread on the STD forum that the Doc responded to.. check it out ("worried about STD scared I may have Herpes") by Edrik11 on 10/31/2006.  Sparkeler has a good comment in there regarding Herpes as well.


I've repasted Doc's answer here to Edrik11's situation of having RECEIVED oral sex and a handjob, so his situation is a little different than yours, but nonetheless, LOW risk.  Read Doc's response to Edrik's situational questions below here or in the thread directly:

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The chance of acquiring any STD by receiving oral sex is very low, and with such a brief exposure, it is close to zero. Herpes is one of the risks, but only for HSV-1, and the odds are at least even that you already have been infected and therefore immune to getting it again. And your symptoms don't sound like herpes, and they came on to soon to have anything to do with the event you describe.

1) Of course not. No STD is transmitted with anywhere near 100% efficiency. Even if she had oral HSV, the odds are overwhelming you did not catch it.

2, 3) When people develop symptoms, the onset usually is within 10 days. But some infected people don't develop any symptoms.

4) Herpes is the highest risk STD from oral sex, but still low for any single exposure.

5) Oral herpes is totally unrealted to a person's sexual history. If your partner has had 2 other lifetime partners or 200, her risk of having oral herpes is the same. You really aren't at risk for any other STD.

Your symptoms have no logical explanation except anxiety. You are blowing this exposure (no pun intended) all out of proportion. Just forget it.

HHH, MD

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Again, Doc, sorry to repaste. But just trying to help you all out and anyone asking the same ole questions. let me know if I am pasting too much redundant information. Thanx!

-WorriedUS

[H. Hunter Handsfield, M.D.]

Referring to previous threads if fine. But please just post the link, don't re-copy the entire reply or thread.  Most users don't want to wade through such long responses after my initial reply.

HHH, MD

[StudentTroubled]

Thank you guys for the comments. Its conforting to hear that my 7 week test result is pretty accurate, but I am definatly not going to be assured until I get re tested at 12 weeks mark.  As for the comment from Dr.H that HIV is uncommon in Japan, it actually is an epidemic now. The number of HIV infected people started to increase tremendously from 2004, and it currently is a very serious situtaion.  This is the link from a news article 2 years ago:

http://www.cbsnews.com/stories/2005/06/04/health/main699681.shtml

I am not circumsized and I understand that recent studies have shown reasonable doubt that the virus could be transmited through the HIV-susceptible Langerhans

[who_dis]

You have a far, far, far higher chance of being killed in a car accident, hit by a bus, or being struck by lightning this week, than contracting HIV from your "exposure".  Worry about those things, not HIV.  You don't have it.

[H. Hunter Handsfield, M.D.]

You need some lessions in critical thinking.  Relying on news reports and interpreting them out of context is just about the worst possible way to judge the epidemiology of AIDS in Japan or anywhere else.  HIV/AIDS may be rising in Japan, as in all countries, but it remains uncommon in comparison with most countries.  And nobody ever got HIV by receiving fellatio.  Circumcision increases the risk, but when the risk is zero anyway, doubling the risk still leaves zero.

who_dis speaks truth.

HHH, MD