Brief Unprotected

[Doolally]

Hi Doc,

I'll keep it brief, as I've seen you've answered countless questions like this on the forum. However, anxiety won so I have relieved myself of a tenner. I'm a 38 year old man from the UK. Approximately 2 weeks ago I met a girl in the UK; we had unprotected oral (both ways) and a very brief period of unprotected vaginal sex, 5-10 seconds, after which we thought better of it and continued the oral. I am not concerned about the oral, from what I have read.

I tested negative for all STDs in 2005, since then I've had only one partner, my long-term girlfriend, other than this encounter. I'm unsure of the girl's status, but have no reason to believe she is HIV+, and I know she is not an IV drug user. She is however, a lap dancer (doesn't sell sex), and this was not a commercial transaction. At present, I am unable to ask her.

My question is, how much of a risk was this, and is HIV testing warranted? I have already tested for other STDs, and am waiting on the results. I am not overly anxious (other than the infidelity issues); if you tell me to stop worrying then I'll put it behind me. I'd very much value your opinion, however, and as I work with statistics, a 1 in x number would be great :)

Best Regards
Doolally

[Doolally]

Thanks Doc

One in ten million is good enough for me to relax about the situation.

I was tested for other STDs a few days ago at my local GUM clinic, am waiting on the results.

I'll second your comment about the clinics, I have received nothing but excellent, non-judgmental advice there, and was dealt with extremely courteously and speedily. If anything in the UK is reading this, then I wouldn't hesitate to arrange an appointment if you have any worries.

Thanks again, and happy new year.

D.

[H. Hunter Handsfield, M.D.]

There is very little if any HIV risk from this sort of encounter.  First, HIV transmission is very rare via oral sex -- and the virus has never been reported to be transmitted by cunnilingus, in either direction.  Second, the average risk for a single episode of vaginal sex is in the range of once for every 1,000-2,000 episodes -- and that risk assumes intercourse to completion, and presumably the risk would be very much lower for the brief period you describe.  Third, those figures apply only if one person has HIV, and the odds are overwhelming that your partner isn't infected.  Of course, I cannot know that with certainty, but in the UK fewer than 1 in 1,000 female sex workers has HIV and of course it is still lower in non-CSW women.  
In response to your request for a quantitative answer, it won't be different than all the others I have done in response to identical questions.  Estimating on the high side, let's say 1/1000 risk your partner had HIV and 1 in 10,000 transmission risk if she did.  Your odds come to 0.001 x 0.0001 = 0.0000001, or 1 in 10 million.  For practical purposes, that's zero.  (It was higher risk for other STDs.)

From a risk assessment perspective, you definitely don't need HIV testing.  On the other hand, all people who are sexually active outside mutually monogamous relationships should be tested for HIV and for common STDs from time to time, like every 1-2 years.  So if you haven't been tested recently, this probably is a good time, while it's on your mind.

The UK has just about the world's best system of STD care in its network of genitourinary medicine (GUM).  If you decide to be tested for HIV and/or other STDs, you can't go wrong to visit your nearest GUM clinic, for the highest quality personal advice as well as technologically top-line services.

Best wishes-- HHH, MD