Cunnilingus risk and worried

[donqqq]

Hi doctors.  
I did a stupid thing while attending a convention in LV, I had sex w a young expensive call girl.  Deep kissing, oral sex both ways and protected vaginal sex once.  I am now worried about the deep kissing and the cunnilingus as I tasted some cum.  I didn't see any lesions on her genital or any blood or my condom or the bed.  I didn't have any sores in my mouth either. I am usually pretty careful but I lost it this time in the heat of passion.  Only four days after, I had some chills, fatigue and post nasal drips, but no high fever, aching or general malaise.  A day after I had some throat irritation but no sore throat or lymphadenopathy.  All symptoms went away after five days.  At about the same time my son had some cough and few days later my wife had some cough, but I didnt have much cough.  Oh I was also on a new BP med, Bystolic, and I thought that could have caused the chills and fatigue.  Now I am suffering anxiety disorder from reading too much info and I promise not to be stupid ever again!
I have read that studies on oral sex showed mixed results from zero to ?eight percent transmission rate in MSM.
1)  Can acute HIV symptoms happen only after 4 days? or mines are more likely a cold?  2)  In your experience have you seen or even suspected any case of female-male transmission via oral sex only?  3)  Should I pay for the expensive PCR test after 3wks or it's ok to wait to do the Elisa after 3mos?  I know the risk of oral sex is very low but not zero.  I am hoping the rate is not that high like one study.  I think most heterosexuals now practice safe vaginal sex but not oral sex so if the the rate of oral sex is high I would think all the std clinics in this country would have noticed it after all these years.  Thank you for helping me with your expert advise.

[Edward W Hook, MD]

Welcome to our Forum.  I'll be happy to comment.  First, it is unlikely that your partner had HIV or any other STD.  it's bad for business and statistically uncommon.

Second, I'm not sure where you read that oral sex could lead to HIV acquisition but it is incorrect. There are NO scientifically proven cases in which HIV has been spread through either kissing or through oral sex and this is the case whether  or not there were sores present (on either partner), blood in the mouth, etc.  Thus there is no risk of you getting HIV from the exposures you describe and thus no reason for concern.  In fact, you really do not even need testing.  

As for your symptoms- they began sooner than would be expect for HIV.  My guess is that you caught a cold, perhaps the same one your son had.  

I urge you not to worry. EWH

[Edward W Hook, MD]

I'm glad I could help. Take care.  EWH

[donqqq]

I just want to follow up since you have relieved most of my anxiety.  I did an Ab test anyway for self-assurance after 6.5wk (45d) which was negative.  Thank you doctor and good luck to everyone!

[Edward W Hook, MD]

As I have said, there are no scientifically convincing studies suggesting that HIV is spread through oral sex.  Conjecture from small, earlier studies is frequently misleading.  EWH

[donqqq]

Hi Dr. Hook
Thank you so much for your comment to relieve my concern.  The info I got was from a study done in SF in 2000 Dillon et al. which showed 8/102 homosexual males possibly got transmission via oral sex.  This result has been much disputed when two later and larger studies done also in SF in 2001 by Balls et al and 2002 by Shafer et al showed no conversion in over 400 homosexual males.  Also there was that Spanish study by del Romero in 2000 which showed no conversion in 135 heterosexual couples.
Do you think that the earlier studies are sometimes bias and the later studies are more accurate. I do value your professional opinion since you are an expert clinician in this area and I am sure you have seen many people w similar oral sex concerns over the years. I am studying to be a medical doctor so I read alot.  Thank you again!