oral sex and acid reflux

I was wondering about the risk of HIV transmission for insertive oral sex on a man, with ejaculation.  I do know that the risk is small, minus extenuating factors like cuts in the mouth or bleeding gums.

Anyhow, I have GERD and am on medication to treat it; however, a few days ago I performed oral sex on a new guy whose HIV status I do not know.  I swallowed, and I hadn't been taking my medication for a week or so prior.  
I think my risk situation is a tad different since I have acid reflux.  Of course, I have no way of knowing if and to what extent my throat is damaged.  But if it isn't too much trouble, please let me know what you think.  I'm extremely worried.  Thank you so much.

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.

Certainly you are correct on one point: This is a unique question, indeed the first time I have ever been asked -- on this fourm or anywhere else -- about GERD as an HIV risk factor.

MIght it actually be a risk factor?  I doubt it, but to my knowledge there has been no research on it.  But the worst case scenario might be a doubling of the risk, if exposed to the virus.  (That's the risk with other inflammatory conditions, e.g. herpes, and in men who are uncircumcised.)  But I stress "if exposed".  If your partner isn't a gay/bi man, injection drug user, etc then most likley he isn't infected.  And in any case, oral exposure to infected semen appears to carry something like a 1 in 10,000 risk of infection.  If you double that, it's still only 1 in 5,000.  That's equvalent to giving oral sex to HIV infected men once daily for 14 years and maybe never becoming infected.

If you have strong reason to believe your partner had HIV, then having an HIV test would make sense.  But that advice would be no different with or without GERD.  If he is at low risk, and especially if he says he doesn't have HIV (did you ask?), I wouldn't worry about it and would not recommend testing.

I hope this helps.  Best wishes--  HHH, MD

[H. Hunter Handsfield, M.D.]

This question should have been on the HIV forum; sorry I didn't think of this before responding. Because it's the wrong forum, there won't be any follow-up discussion.