Brazil, Drunk, Sex workers, unprotected oral, HIV

[Stupid_in_rio]

Hi Doc,

Ive been through most of the postings concerning unprotected oral.  Most of them are men who have had an exposure for 3 minutes or so.  Here is my situtation.  

I went to brazil about a month ago with my buddy.  We had a sexual encounter every night with a working girl.  5 different girls over 7 nights.  Each girl allwoed me to ejaculate multiple times.  Of course I was drunk every time.  Every girl I had protected vaginal sex, no condom breakage and I asked if they get tested and if they had anything.  2 of the girls performed oral on me multiple times.  One of them swollowed during my ejaculation.  Those 2 same girls allowed me to perform Oral on them.  All oral exposures both receiving and giving were all over 5 mins and I have to say it happened 7 times between them both.  I went to the dentist 2 months prior to the trip and have no gum disease.

I do have an alcohol problem and I do have a girlfriend at home while I am cheating on her with another girl.  The girlfriend is away working the past month and I am seeing her in two weeks.  I have not seen her since my trip.  The affair girl I have protected sex with.
I recently went for a HIV oraquick rapid blood test at 26 days since the trip and came back negative.  Two days after my trip I has a very slight swollen gland in my neck which lasted for a day.  During my trip I had a irritation on the tip of my penis, no discharge, no burning, a slight irration that made me pee alot.  It went away.  Remind you I drank alot of alcohol on this trip with little water.  I usually drink 8 cups of water a day.
Here is my scenerio and your response is much appreciated.  This forum is a great help to many.

Questions,

1.  What is my risk of HIV even after my negative test after 26 days?

2.  Should I get tested again?

3.  Should I be worried at this point about passing any other diseases onto the other girls I am seeing?

4.  Working girls in Brazil, I recently read about Brazil being applauded on their HIV prevention among working girls.  Should I beleive the girls status even when they told me?  Many of the girls have no choice to the means of how they make their money.

5.  What the hell was that irritation that made me pee?

Thanks so much,

Drunk in Brazil

[H. Hunter Handsfield, M.D.]

Whatever the risks is for any particular type of exposure, of course it increases with the number of events.  But when the risk is virtually zero anyway, it doesn't matter:  double a near-zero risk is still near zero.  There are no proved cases of HIV acquired by receiving oral sex, or by performing oral sex on women.  If it occurs, it is too rare to measure or worry about, regardless of duration of exposure and with or without ejaculation.

1) About 90% of infected people will have positive tests by 26 days.

2) Given how low your risk was anyway, I do not recommend further testing.  But if you remain unconvinced, have another test 6-8 weeks after the exposures.

3,5) The burning is unlikely to be due to an STD from the events you describe, unless you are having abnormal discharge from the penis.  As to other possibilities, it's anybody's guess.  Not knowing the cause, I cannot judge the risks to your partners.  See a health care provider for examination and possible testing.

4) Most people do not lie when asked directly about HIV status, but of course there are exceptions.  I'm not familiar with HIV frequency in Brazilian sex workers.

Good luck--- HHH, MD

[sparkeler]

Wow, are you a busy boy?  Your sex is protected, so I would feel very reassured your not going to catch an std.   You are acting sexually responsible.  However, the doctor suggests you test once a year for stds/hiv if you are outside mutually monogomous relationships.  Although 26 days is a little too soon to test by all medical standards, most people seroconvert within 21 days.  They say 6 weeks is plenty of time and 3 months you are gaurunteed to be hiv negative.  But since you practice safe sex, I would feel assured your hiv negative and will remain that way.  Stay safe.