advice on testing

Hi, I am a 26 yr old male who lives in the UK and here are my exposures.

Mid 2007.
Had protected vaginal sex with a female escort. Penetration lasted about 10 minutes.  Had HIV symptoms between 2 – 8 weeks after like sore throat, diaheria, sickness, night sweats & mouth ulcer, even though I used a condom. Also received oral without a condom. I decided to test for HIV, STD & Hep B 5 weeks later at a gum clinic. All results where negative/clear of diseases. I presume the HIV test was an antibody test.

Apr 08
Had protected sex and received oral sex from a female escort – both protected using a condom. We changed the condom after the oral and used a fresh one for the vaginal sex. Penetration lasted about 5 / 6 minutes. I asked the girl about STD’s and she said she was clear and gets tested every 8 weeks.

Jun 08
Protected sex and received oral sex from a female escort – both protected using a condom. Penetration lasted about 3 / 4 minutes.

Sept 08
Protected vaginal sex with a female escort. Penetration lasted about 5 / 6 minutes. Received oral without a condom, therefore went for get tested for Chlamydia and Gonorrhoea 10 days later and none of theses showed up/negative.  

Jan 09
Protected vaginal sex but received unprotected oral, again from a female escort. I asked the girl about STD’s and she said she was clear and gets tested once a month.

Basically I’ve always had vaginal sex, no anal sex, always used a condom for penetration, had a negative HIV in mid 2007 (albeit only 5 weeks after my last bout of protected vaginal sex) and had protected sex with 4 female escorts since. I tested clear for Chlamydia & Gonorrhoea after receiving unprotected oral back in August 2008 and I have only recieved unprotected oral once since then (had no std symptoms)

Would you say my risk for HIV is low?
Is it unlikely that all, of even just one, of the girls I had protected sex with had HIV?

[Edward W Hook, MD]

Your risk is very, very low.  For starters, chances are that your partners did not have HIV.  Most commercial sex workers do not and your partners are at lower risk than CSWs met through other, more casual circumstances.  Then you used condoms for all of your vaginal sex and condoms work.  The only exposures you had which put you at any risk at all are your unprotected oral sex encounters and there is debate as to whether there is any risk of getting HIV from receipt of oral sex.  The "conservatives" who  feel that there may be some risk put the risk at no greater than 1 infection per 10,000 exposures to HIV infected partners and many experts feel that the risk is lower and perhaps zero.

No matter how you approach it, the risk of HIV from the encounters you describe is very, very low and approaches zero.  Having said that, there are a few STDS, most notably gonorrhea and non-chlamydial nongonococcal urethritis which can be acquired from unprotected receipt of oral sex.  Thus you qualify for periodic STD "screening (testing in the absence of symptoms) because you have had multiple partners over a period of less than a year.  As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).  Whether or not you get an HIV test at the time of screening is your call.  There is no downside and it may be reassuring ( and no, this is not a "back door” way  of implying your risk is substantial - if you were concerned enough to pay for this comment, it is on your mind.).

Hope this helps.  EWH

[robbieward32]

P.S - Forgot to say, these weren't escorts I picked up from the street etc. I used them thru an agency.