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HIV Prevention (Expert Forum)
Worried
Answered by
University of Washington
Seattle - WA
This forum is limited to prevention of HIV and to safe sex in general. If you believe you might have been exposed to HIV and want help to judge your risk, would like advice about HIV testing, or have questions about the effectiveness of condoms or the risks associated with specific sexual practices, this is the site for you.
IMPORTANT
No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
Worried
by teddy55, May 06, 2008 10:15AM
Dr. HHH
Based on my research you are the most knowledgeable person in the world on HIV prevention and I want to thank you for lending your expertise to this board.
I am a happily married male who recently had an encounter with another women of unknown status. I never thought I would be in this situation and it has caused me great guilt. The women of unknown status only preformed oral sex on me. It was unprotected and lasted probably 2 to 5 minutes before I asked her to stop. Afterwards she told me she was also married, but was a swinger who has women, women, male sex about once every three months. She also told me she has been to rehab for Cociane and pills. I do not use drugs. I also do not believe that I had any cuts on my penis.
I did not see any cuts or blood in here mouth. After she told me about her swinging and drug use I freaked out and ran out of her hotel room. I wished I would have stayed and asked her about her testing habits and status, but I did not. I understand this is probably a low risk occurrence (I believe 1 in 20,000, but please correct me if I am wrong) , but there are two twist.
1) She used a lot of teeth for a few, probably 5-10, seconds
2) My wife has genital herpes and I am unsure if I have it or not. I have never been tested and we never use protection and she only takes meds when she has a break out. We don’t have sex during her break outs. I have never had any symptoms of hereps.
My wife and I were tested for HIV around a year ago and we were both negative. I have had no other partners but her since our marriage, expect for this one time mistake..
My questions are:
1) Are my risk for HIV still very close to zero (1 in 20,000) even though I may have genital herpes.
2)Should I get tested?
3)I have scheduled a RNA test in a few days. Are this accurate with one week or should I wait longer.
4) Should I not have sex with my wife until testing? If we did what are her risk?
Thanks Doc
Based on my research you are the most knowledgeable person in the world on HIV prevention and I want to thank you for lending your expertise to this board.
I am a happily married male who recently had an encounter with another women of unknown status. I never thought I would be in this situation and it has caused me great guilt. The women of unknown status only preformed oral sex on me. It was unprotected and lasted probably 2 to 5 minutes before I asked her to stop. Afterwards she told me she was also married, but was a swinger who has women, women, male sex about once every three months. She also told me she has been to rehab for Cociane and pills. I do not use drugs. I also do not believe that I had any cuts on my penis.
I did not see any cuts or blood in here mouth. After she told me about her swinging and drug use I freaked out and ran out of her hotel room. I wished I would have stayed and asked her about her testing habits and status, but I did not. I understand this is probably a low risk occurrence (I believe 1 in 20,000, but please correct me if I am wrong) , but there are two twist.
1) She used a lot of teeth for a few, probably 5-10, seconds
2) My wife has genital herpes and I am unsure if I have it or not. I have never been tested and we never use protection and she only takes meds when she has a break out. We don’t have sex during her break outs. I have never had any symptoms of hereps.
My wife and I were tested for HIV around a year ago and we were both negative. I have had no other partners but her since our marriage, expect for this one time mistake..
My questions are:
1) Are my risk for HIV still very close to zero (1 in 20,000) even though I may have genital herpes.
2)Should I get tested?
3)I have scheduled a RNA test in a few days. Are this accurate with one week or should I wait longer.
4) Should I not have sex with my wife until testing? If we did what are her risk?
Thanks Doc
Doctor's Answer
by H. Hunter Handsfield, M.D., May 07, 2008 03:37AM
, May 07, 2008 03:37AM
Thank you for the confidence, but I am far from the "most knowledgeable person" on HIV transmission issues. 99% of the people who are experts in this arena just don't have online forums.
Receiving oral sex is such low risk for HIV transmission that some experts believe it never happens; the 1 in 20,000 risk is the maximum estimate. Even this risk assumes your partner had HIV, which is unlikely, despite her drug history. I suppose your risk might be a little higher, since you have genital herpes -- but still too low to worry about. Like a lot of people, you apparently have an inflated perspective about HIV frequency in heterosexual men and women in the US.
To the specific questions:
1) So what if your risk was eleveated to, say, 1 in 10,000? If you assume a 10% chance your partner had HIV, that translates to a 1 in 100,000 risk you caught HIV. Put that in perspective: If you live in the US, your risk of dying of an accident in the next 12 months. That is 57 times higher than the chance you caught HIV.
2,3) From a risk assessment or medical perspective, you do not need HIV testing on account of this exposure, and RNA testing is not smart. The chance of a false positive result is higher than the chance you were infected. Think what you'll go through for several days if the RNA test is positive, but turns out to be false. It isn't worth the time and energy. If you insist on testing for the psychological reassurance it might give, just have a standard antibody test 6 weeks after the event. You can be sure of a negative result. (If it were positive and you were my patient, my first response would be to look you in the eye and say "OK, let's talk about your real risks. You didn't get it from the ** a few weeks ago.")
4) I never guarantee someone isn't infected. But if I were in your situation, I would not hesitate to have sex with my wife.
I hope this helps. Best wishes. (And don't forget to use your seatbelt.)
Regards-- HHH, MD
Receiving oral sex is such low risk for HIV transmission that some experts believe it never happens; the 1 in 20,000 risk is the maximum estimate. Even this risk assumes your partner had HIV, which is unlikely, despite her drug history. I suppose your risk might be a little higher, since you have genital herpes -- but still too low to worry about. Like a lot of people, you apparently have an inflated perspective about HIV frequency in heterosexual men and women in the US.
To the specific questions:
1) So what if your risk was eleveated to, say, 1 in 10,000? If you assume a 10% chance your partner had HIV, that translates to a 1 in 100,000 risk you caught HIV. Put that in perspective: If you live in the US, your risk of dying of an accident in the next 12 months. That is 57 times higher than the chance you caught HIV.
2,3) From a risk assessment or medical perspective, you do not need HIV testing on account of this exposure, and RNA testing is not smart. The chance of a false positive result is higher than the chance you were infected. Think what you'll go through for several days if the RNA test is positive, but turns out to be false. It isn't worth the time and energy. If you insist on testing for the psychological reassurance it might give, just have a standard antibody test 6 weeks after the event. You can be sure of a negative result. (If it were positive and you were my patient, my first response would be to look you in the eye and say "OK, let's talk about your real risks. You didn't get it from the ** a few weeks ago.")
4) I never guarantee someone isn't infected. But if I were in your situation, I would not hesitate to have sex with my wife.
I hope this helps. Best wishes. (And don't forget to use your seatbelt.)
Regards-- HHH, MD
Dear frined your state is similar to mine, that i was an insertive partner of Oral sex and also that it was the only one episode of Oral sex that I did in my whole life.(it a great guilt that I am trying to forget, but I thank the Allah "God" that i am a negative of rapid HIV1/2 test after 7.5 month from that event.
Dr HHH wanted to tell you, that you really really don't have HIV from the same exposure that you did.
And as for Dr HHH I am going to say him that , really you are so humble and I think or as it were I am sure that all of us like and respect you and dr HooK , Not becasue both of you help the others but also becasue both of you give the others a satisfying answers that help them to understand their states.
Thanks a lot for Dr HHH and HooK and I wish to be a lot of you in our world.
Thanks again and I will take your advice on the RNA.
It's up to you whether to be tested HSV. Search the STD forum for innumerable discussions about HSV diagnosis, transmission risk, etc. You can also find many references there to excellent websites with information about genital herpes.
Also what are the % for an accurate test at 3, 4 and 5 weeks. Thanks
The time to positive HIV tests has been repeatedly discussed on this forum. Read any of the existing innumerable threads. The bottom line is that if you get tested at all, I suggest you have a single antibody test around 6 weeks after the event you are concerned about.
That's it for this thread. I won't have any further comments.