HIV/STD Infection with multiple exposures

I am really scared and worried from past two months and I even lost some 6 LBS in less than 30 days

Q1).I am a male and  I received oral sex from a high risk female (escort) in the NY area for less than 20 to 30 seconds after that she made me wear a condom.

Q2). After wearing a condom I was lying on her and I was kissing her neck for about 2 to 5 minutes and when i got up i saw that my condom was not on my penis ( my penis was either on her stomach or near her vagina ..May be a genital contact and I am sure she was not wet at all) and I did not penetrate at all (may be only frottage). Do you see any problem here.... I did not had any type of vaginal or anal intercourse....the only thing i am worried about is I had penis touch outer-courses of her vagina very briefly...but with no penetration ( no vaginal and no anal sex) and she was not wet.

Q3). I had an outbreak of oral Herpes( cold sore) on my upper lip(very small in size)  it was not bleeding or cut but it was swollen  and I kissed the following areas  like her shoulders, back, neck, buttocks, legs, cheeks, thighs etc but NOT her mouth, vagina or anus. Do you think she might have had some dried semen from her other customer on her skin that may have penetrated my skin through my oral herpes?


Q4).After reading a lot about STDs at  4th  week I felt tingle on the tip of the penis and it was stinging a bit like  for every 3 to 4 hours  so I went and got tested myself for Hep B, Chlamydia, Gonorrhea, Genital herpes, Syphilis and  they all came back negative.

This is my only exposure I had in my entire life. I am a heterosexual male and I am not a drug user or anything.

Questions # 1: Do you see any risk for HIV?
Questions # 2: Do you see any risk for HIV?
Questions # 3: Do you see any risk for HIV?
Questions # 4: Should I test again for any STD

[H. Hunter Handsfield, M.D.]

Too many questions for detailed responses to all of them.  My overall response is that you are much too worried given the low risk of the exposure you describe, and tht your PCP is right.

In the US and other industrialized countries, most escorts (i.e., higher class commercial sex workers) probably are careful about STD risks and are pretty low risk for being infected with either HIV or other STDs.  The notion that some other partner's semen was still on her body when you had sex with her is ludicrous.  (You don't think she showered between partners???)  Even if so, there is no way you could acquire an STD that way.  The indirect penile contact you describe with her body is virtually zero risk, even if she were infected.  Your symptoms do not suggest ARV or any other STD, especially since your tests were negative, and the minor increase in frequency of your recurrent oral herpes undoubtedly is nothing but random variation in outbreaks. You do not need additional testing for any STD, unless your own doctor recommends otherwise.

Bottom line:  The risks were low from the exposure you describe and you can be confident you aren't infected with anything.  Put it out of your mind and go on with life.

Best wishes and happy new year--  HHH, MD

[LoneRanger]

Dude, there's no known case of getting HIV from a woman when she blows your piece. If you could get HIV that way, the entire gay population in the world would be dead by now.

[myfear]

Doc,

Have you made the below comment thinking that i have already tested for HIV or based on my exposure...

Bottom line: The risks were low from the exposure you describe and you can be confident you aren't infected with anything. Put it out of your mind and go on with life.


Please Doc, Help this worried man.

[strangeworld]

Dr. HHH
I forgot to mention insertive unprotected oral sex.

[WG1003]

Have the test. Enough time has passed that an HIV test would be accurate at this point. And it would go miles to putting your mind at ease.  

Honestly, your fears of HIV and STD's from this exposure are unfounded. The science of STD's (including HIV) doesn't work with the situation you described. Often, stress is enough to cause a Cold Sore outbreak.

Remember, HIV is hard to transmit. Under these conditions, I would say it was impossible. Your other tests came back clear. You can assume the HIV will, too.

And ARS symptoms will not be occuring after two months. They generally happen within the first month and come and go very quickly.

[H. Hunter Handsfield, M.D.]

In my initial response, I assumed you had already been tested for HIV.  If not (as implied by the response from WG1003), you should do it--not because I believe you are infected, but because the negative result probably will be more reassuring to you than my assessment of your near-zero risk.

HHH, MD

[myfear]

Was my unprotected insertive oral sex was a higher than my other risks or all those exposures were low risk and near-zero?

Please help.

[H. Hunter Handsfield, M.D.]

This is not a counseling service. All I do is provide STD information as objecively as possible; the rest is up to you.  See a health care provider if your concerns persist.

HHH, MD