Aa
Still scared of a possible HIV transmission
Hi Dr. Handsfield,
I posted this question on the community forum a couple of days ago, and received what seemed like informed and detailed answers, but still I need more reassurance; I have also looked at previous posts related to my situation in order to get a better idea of where I stand; I am listing what are more or less the contents of my original question:
I'm a 28 year old male living in the South of England, UK. Last Thursday, after having a few drinks, I foolisly went and found an escort/sex worker from the internet, of unknown HIV status. We french-kissed intensely for a bit, and I also bit her but this was rather mild, and not enough to cause a cut of any sort I would have thought. She then touched my testicles, at which point I ejaculated. She wipped me clean, and then proceeded to kiss/lick my penis, I think at the top, twice, for a cumulative period of about 2-3 seconds. At that point, I realised what I was doing was wrong, said I was tired, and left the scene. When I arrived home after about 10 minutes I had a shower, and went to sleep. The next day, and for the following couple of days, I noticed a slight bitter sensation in parts of my tongue and lips, but this eventually went away; other than this, no other symptoms, and it has been 6 days since my encounter.
I'm going HIV-scared-mad, to the point where I'm having trouble breathing properly and getting any work done at all. From what I gather, the only real danger for me getting infected with HIV is the theoretical case where the sex worker was bleeding too heavily to perform oral sex, as the virus is not that easy to transmit?
I didn't see, taste or smell any traces of blood, but I keep wondering to myself, what if, what if, what if. Could I potentially have contacted HIV this way, or am I worrying for no reason? Would the alcohol I had consumed negatively alter my tolerance in any way?
Also, would you suggest I undertake a test, for any reason other my own peace of mind?
Kind Regards
I posted this question on the community forum a couple of days ago, and received what seemed like informed and detailed answers, but still I need more reassurance; I have also looked at previous posts related to my situation in order to get a better idea of where I stand; I am listing what are more or less the contents of my original question:
I'm a 28 year old male living in the South of England, UK. Last Thursday, after having a few drinks, I foolisly went and found an escort/sex worker from the internet, of unknown HIV status. We french-kissed intensely for a bit, and I also bit her but this was rather mild, and not enough to cause a cut of any sort I would have thought. She then touched my testicles, at which point I ejaculated. She wipped me clean, and then proceeded to kiss/lick my penis, I think at the top, twice, for a cumulative period of about 2-3 seconds. At that point, I realised what I was doing was wrong, said I was tired, and left the scene. When I arrived home after about 10 minutes I had a shower, and went to sleep. The next day, and for the following couple of days, I noticed a slight bitter sensation in parts of my tongue and lips, but this eventually went away; other than this, no other symptoms, and it has been 6 days since my encounter.
I'm going HIV-scared-mad, to the point where I'm having trouble breathing properly and getting any work done at all. From what I gather, the only real danger for me getting infected with HIV is the theoretical case where the sex worker was bleeding too heavily to perform oral sex, as the virus is not that easy to transmit?
I didn't see, taste or smell any traces of blood, but I keep wondering to myself, what if, what if, what if. Could I potentially have contacted HIV this way, or am I worrying for no reason? Would the alcohol I had consumed negatively alter my tolerance in any way?
Also, would you suggest I undertake a test, for any reason other my own peace of mind?
Kind Regards
MEDICAL PROFESSIONAL
Welcome to the forum.
I'll try to help, but I'm not sure I can. All I can do is reiterate the scientific facts and the reasoned reassurance you already had on the community forum. Your problem isn't understanding the facts and probabilities, but in converting that reassurance into emotional belief and acceptance. And that's a psycghological issue that isn't likely to be helped by hearing the same facts again. But here we go:
A partner like you had is extremely unlikely to have HIV. Even if she had it, hand-genital contact and oral sex carry no significant HIV transmission risk. One estimate, from CDC (the US equivalent of UK's Health Protection Agency) is that if an oral partner has HIV, the average transmission risk to a penile partner by oral sex is 1 in 20,000 -- equivalent to receiving oral sex by HIV infected partners once daily for 55 years before getting infected. And that's with prolonged oral sex, not the fleeting contact you describe. Alcohol does not increase susceptibility to HIV.
Based on risk assessment and common sense, you definitely do not need HIV testing. But whenever a person is worried, it's always best to be tested, for exactly the reason you state. As I said above, my guess is that my reassurance isn't going to resolve the problem. Perhaps having a negative test will help you deal with this situation. (This is not "code" to suggest I really believe there was any risk of HIV. There was not.)
I hope this helps a bit. If it doesn't, you may need to consider professional counseling. It really isn't normal to be "HIV-scared-mad" in such a situation. I suggest it out of compassion, not criticism.
Regards-- HHH, MD
I'll try to help, but I'm not sure I can. All I can do is reiterate the scientific facts and the reasoned reassurance you already had on the community forum. Your problem isn't understanding the facts and probabilities, but in converting that reassurance into emotional belief and acceptance. And that's a psycghological issue that isn't likely to be helped by hearing the same facts again. But here we go:
A partner like you had is extremely unlikely to have HIV. Even if she had it, hand-genital contact and oral sex carry no significant HIV transmission risk. One estimate, from CDC (the US equivalent of UK's Health Protection Agency) is that if an oral partner has HIV, the average transmission risk to a penile partner by oral sex is 1 in 20,000 -- equivalent to receiving oral sex by HIV infected partners once daily for 55 years before getting infected. And that's with prolonged oral sex, not the fleeting contact you describe. Alcohol does not increase susceptibility to HIV.
Based on risk assessment and common sense, you definitely do not need HIV testing. But whenever a person is worried, it's always best to be tested, for exactly the reason you state. As I said above, my guess is that my reassurance isn't going to resolve the problem. Perhaps having a negative test will help you deal with this situation. (This is not "code" to suggest I really believe there was any risk of HIV. There was not.)
I hope this helps a bit. If it doesn't, you may need to consider professional counseling. It really isn't normal to be "HIV-scared-mad" in such a situation. I suggest it out of compassion, not criticism.
Regards-- HHH, MD
MEDICAL PROFESSIONAL
I was aware your comment for Dr. Hook crossed my reply "in the mail" and I didn't take it negatively. Just wanted to be sure you weren't expecting him to weigh in.
A few HIV infected people who claim to have caught it receiving oral sex, and some feel strongly about it. But by and large the transmission route was unconfirmed and many had other potential (higher risk) exposures. Very few infected persons have had only a single exposure; the large majority have had unsafe lifetyoes for many years and can only make guesses and assumptions about when and from whom they were infected. Others simply forgot other exposures (e.g., drunk or high) or lied, i.e. gave face-saving explanations -- consider the married man who claims only a single episode of oral sex in a public toilet, but who in fact has been having sex in bath houses. Such personal histories often are inaccurate. In fact, the data on CDC's estimate of 1 in 20,000 risk for oral sex is based primarily on such personal histories, so that's a maximum risk level for such exposures. This is why some experts (e.g., Teak on the community forum) believe that HIV is never transmitted from mouth to penis. Dr. Hook and I don't go quite that far; we believe there probably have been a few legitimate transmissions. But if so, they are in the probability range of getting hit by lightning.
Alcohol is not likely to enhance HIV transmission risk in the way you describe. As for a "single drop" of blood or other minor exposures, take a look at this thread, which explains the biological basis for transmission of HIV and other STDs. Start reading with the follow-up comment dated Dec 14: http://www.medhelp.org/posts/show/1119533
That should end this thread. Please do your best to accept the reassurance at face value and move on. If you decide to get tested, feel free to post a definitive test result (i.e. 6+ weeks for an antibody test or 4+ weeks for a combo p24/antibody test) -- but until then I'll hae no other comments.
A few HIV infected people who claim to have caught it receiving oral sex, and some feel strongly about it. But by and large the transmission route was unconfirmed and many had other potential (higher risk) exposures. Very few infected persons have had only a single exposure; the large majority have had unsafe lifetyoes for many years and can only make guesses and assumptions about when and from whom they were infected. Others simply forgot other exposures (e.g., drunk or high) or lied, i.e. gave face-saving explanations -- consider the married man who claims only a single episode of oral sex in a public toilet, but who in fact has been having sex in bath houses. Such personal histories often are inaccurate. In fact, the data on CDC's estimate of 1 in 20,000 risk for oral sex is based primarily on such personal histories, so that's a maximum risk level for such exposures. This is why some experts (e.g., Teak on the community forum) believe that HIV is never transmitted from mouth to penis. Dr. Hook and I don't go quite that far; we believe there probably have been a few legitimate transmissions. But if so, they are in the probability range of getting hit by lightning.
Alcohol is not likely to enhance HIV transmission risk in the way you describe. As for a "single drop" of blood or other minor exposures, take a look at this thread, which explains the biological basis for transmission of HIV and other STDs. Start reading with the follow-up comment dated Dec 14: http://www.medhelp.org/posts/show/1119533
That should end this thread. Please do your best to accept the reassurance at face value and move on. If you decide to get tested, feel free to post a definitive test result (i.e. 6+ weeks for an antibody test or 4+ weeks for a combo p24/antibody test) -- but until then I'll hae no other comments.
Dr Handsfield,
Regarding my second post relating to me missing Dr Hook's name when addressing my first post, the second post was sent sortly after the first, but seems to have been registered one hour after the first post, and hence after your reply. It was not meant as an invite for a second opinion, or of not trusting the contents of your answer in any way.
Kind Regards
Regarding my second post relating to me missing Dr Hook's name when addressing my first post, the second post was sent sortly after the first, but seems to have been registered one hour after the first post, and hence after your reply. It was not meant as an invite for a second opinion, or of not trusting the contents of your answer in any way.
Kind Regards
Thank you Dr. Handsfield,
I think you are very accurate when describing my problem as mostly psychological; knowing myself, I'll agree that only getting a negative test result will completely settle the matter for me.
Just a couple of questions, I promise not to elongate the thread unnecessarily, and excuse me if I am reiterating questions that may have been analysed in the past in this forum.
I am still not exactly sure of the basis of the probability of transmission in different sexual acts from the CDC. One of the answers to the original question I posed on the community forum, suggested that the 1 in 20,000 probability may exist exactly because the possiblity is there, no matter how small. But I don't quite understand how, from what I gather, there has never been a single credible, documented case of HIV transmission through oral sex; I would have thought that a 1 in a 20,000 event would have occured at some point to date? Does the 1 in 20,000 probability, factor in circumstances such as extreme bleeding, that never really happen in practice? Also, from what I gather, a large amount of blood seems to be a requirement for transmission to occur? i.e. would a single drop of blood from an HIV+ female touching a male's urethra be considered an insufficient amount for transmission to occur? Perhaps more importantly, does a certain amount of blood have to enter through the urethra, or is just touching the urethra considered a sufficient risk?
Regarding the alcohol consumption, what I actually meant to ask was wether it would have any neutralising effect to my saliva or general oral health, such that it would constitute intense mouth to mouth contact as a measurable risk factor.
Again, sorry if I'm reiterating questions that may have been answered before, or I am being too persistant in my questions.
Kind Regards
I think you are very accurate when describing my problem as mostly psychological; knowing myself, I'll agree that only getting a negative test result will completely settle the matter for me.
Just a couple of questions, I promise not to elongate the thread unnecessarily, and excuse me if I am reiterating questions that may have been analysed in the past in this forum.
I am still not exactly sure of the basis of the probability of transmission in different sexual acts from the CDC. One of the answers to the original question I posed on the community forum, suggested that the 1 in 20,000 probability may exist exactly because the possiblity is there, no matter how small. But I don't quite understand how, from what I gather, there has never been a single credible, documented case of HIV transmission through oral sex; I would have thought that a 1 in a 20,000 event would have occured at some point to date? Does the 1 in 20,000 probability, factor in circumstances such as extreme bleeding, that never really happen in practice? Also, from what I gather, a large amount of blood seems to be a requirement for transmission to occur? i.e. would a single drop of blood from an HIV+ female touching a male's urethra be considered an insufficient amount for transmission to occur? Perhaps more importantly, does a certain amount of blood have to enter through the urethra, or is just touching the urethra considered a sufficient risk?
Regarding the alcohol consumption, what I actually meant to ask was wether it would have any neutralising effect to my saliva or general oral health, such that it would constitute intense mouth to mouth contact as a measurable risk factor.
Again, sorry if I'm reiterating questions that may have been answered before, or I am being too persistant in my questions.
Kind Regards
MEDICAL PROFESSIONAL
Except in unusual circumstances, Dr. Hook and I don't comment on each other's threads. Our opinions and advice never differ significantly.
My apologies,
I did not realise questions posted in the expert forum are addressed to both Doctors; Doctor Hook is more than welcome to comment on my questions of course, should he wish to do so.
Kind Regards
I did not realise questions posted in the expert forum are addressed to both Doctors; Doctor Hook is more than welcome to comment on my questions of course, should he wish to do so.
Kind Regards
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