Need some expert advice

[Bozza73]

Hello Doctor,
Please could you assess my situation as I am going bonkers.
I had not had sexual intercourse for nearly 2 years and 18 days ago stupidity and frustration got the better of me and I arranged to meet an escort (uk) which I found on the internet.

We performed protected vaginal intercourse and she penetrated me anally, twice,  with 2 different strap-ons which she covered with condoms and also mentioned that they were new. Thanks to the useful information on this website I have managed to convince myself that these acts, although perverted, were relatively safe.

Here is my concern:

We performed unprotected oral sex on each other various times, incl 69 for a total of 20 minutes. A lot of her vaginal fluids entered my mouth and on one occasion she 'gushed' into my mouth.  

I have not felt right since this incident and I am very aware that anxiety, stress and guilt play a huge role in any symptoms one may experience. But I am concerned as I have had some mild throat symptoms, dry cough, diarreah, headaches, sweats and the odd body ache.

Would you recommend that I test or can I just book myself in for a brain transplant?

Thanks for your time.
Regards

[H. Hunter Handsfield, M.D.]

Forgive the typo:  escorts generally have LOW rates of HIV infection.

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum. Bottom line:  You are correct that these exposures were safe -- not "relatively", but completely safe.  There was no measurabale HIV risk and no need for HIV testing.

As you already learned on the community forum, oral sex is safe sex with respect to HIV transmission.  Perhaps not totally risk free, but to my knowledge there has never been a confirmed transmission by cunnilingus (in either direction), and although there have been claims of transmission from mouth to penis, many experts believe it never occurs. Dildos and sex toys carrly little risk, especially if cleaned between clients -- and it is unlikely that a knowledgeable escort would not clean them.  Finally, "escorts" -- expensive sex workers -- generally have no rates of HIV infection, and my understand the UK Health Protection Agency has estimated that fewer than 1 in 1,000 London commercial sex workers has HIV.

And I agree with your self-assessment of the likely cuase of your symptoms. When acute HIV infection causes symptoms at all, usually they are quite prominent and substantial fever (>38C) is almost always present.

Here is a thread that discusses the biology of STD/HIV transmission in detail, explaining why exposures like this carry little or no risk.  You should find it reassuring.  Start reading with the folllow-up comments that start December 14:  http://www.medhelp.org/posts/show/1119533

In general, sexually active persons should not seek HIV testing after single exposures; the risk is simply low for that to make sense after individual sexual events, unless they are especially high risk (e.g., unprotected vaginal or anal with a known infected partner).  A smarter strategy is for all sexually active persons, outside mutually committed monogamy, to just have routine STD/HIV testing from time to time, like once a year.  If you haven't been tested recently, perhaps this would be a good time, when it's on your mind.  But not on account of this particular exposure.

Good luck--  HHH, MD

[Bozza73]

Thanks Doctor.
You comments have been helpful. I will try and let this one go.
Regards