Oral Encounter with Variables

[levelheaded]

I am a 23 y/o heterosexual man who, after a night of drinking, brought a 25 year old friend (girl) home from the bar. I received unprotected oral sex for several minutes but did not ejaculate. I fingered her with the same hand I had been using to touch my penis, though I don't think I was while it was still wet. This whole episode was my first sexual intimacy with a woman. I spoke to her on two occasions afterwards and told her I am drug and disease free and she said the same was true for her.

The following Thursday, Friday and Saturday, I went out drinking with my buddies. That Sunday I became quite I'll. Sore throat, fever, fatigue, night chills/sweats and constant diarrhea. These passed within a few days except I had lost my appetite which I did not regain for several weeks. Also have had a persistent sore throat.

1)Because this was my first penetration experience is it possible that it was in any way more traumatic to my body and could've caused a more inviting environment for a potential virus?
2)While receiving oral sex she "deep-throated" me which caused her to gag. Would being taken deep increase my risk to exposure in any way?
3) I realize the symptoms I described earlier are typical of innumerable community acquired viruses, but is it possible that the alcohol could've weakened my immune system and made me more susceptible to HIV, had she had it?
4) I urinated after this whole episode but did not clean my penis until the following day. When unerect, my penis tends to slide back into itself a bit, in towards my body. I am wondering if the virus could have potentially been harbored in that area and led to a greater chance of infection.
5)It is possible that my penis could have been irritated from earlier masturbation. Would this make any difference in my likely hood of attaining HIV?

Out of anxiety, I got tested a 4 weeks and will get the results tomorrow. Would you suggest that I do another test at 6-8 weeks, or is this one test sufficient?

[Edward W Hook, MD]

Your risks are near, if not at zero.  Receipt (or, for that matter giving) oral sex is of minimal risk and skin to skin (i.e. finer to penis in your instance) contact is safe sex, even if there are secretions present.  In addition, she has indicated to yo that she has no known diseases, making it even less likely that you were exposed.   On to your specific questions:

1.  No, there is no reason to think that first experiences are associated with increased vulnerability.
2.  No, none what so ever
3.  No, acute alcohol ingestion does not have signifcant effect on your ability to ward off infection.
4.  No.  The exposure was safe.
5.  No (and remember, she is very unlikely to be infected).

At 4 weeks 85-90% of tests that are going to be positive will be.  If you had asked before you got tested, I would have said there was no reason for you to be tested.  When the result from your 4 week test comes back negative, you have made the near zero probability effectively zero.  There is no reason for further testing.  Hope this helps.  EWH  

[levelheaded]

As you said, the tests did come back negative today. Having known from the beginning that I was low risk for acquiring anything, I had the test done to quell the anxiety I had of being the 1 in a million who gets unlucky. In that respect, I think I am similar to many on this forum. I'd just like to use this follow-up to sincerely thank you for providing timely and useful information for those of us who do not have the comprehensive understanding of the intricacies of infectious diseases as you do. It is comforting to get the facts along with reassurance from someone of your stature. I hope your colleagues in the medical community recognize the valuable service that you and Dr. Handsfield provide. Thanks again and best wishes for the future.