Worried Sick about Risk

[worriedsick1982]

Hello doctors, thanks for all your work in this site.  I've been reading it ever since my exposure in August of 2008.  I've seen many similiar questions, but here we are in March and the anxiety is killing me.  

In August 2008 I was at a buddies bachelor party and we ended up at a strip club in Baltimore in an area where prostitutes are common.  So I wandered out of the club and long story short ended up in an alley with a prostitute.  She gave me unprotected oral for literally two *****, then I pulled out because I felt guilty about my fiance.  Now I am extremely concerend about my exposure because I have since developed a purple, circular blemish on my chest, albeit the size of a que tip, and am concerned it's an indication that I have HIV.  Furthermore, I have been having unprotected sex with my fiance and back in December she developed hives all over her body, they came and went within hours, but she still went to the doctor who told her that it was an allergic reaction.  Her skin now is sensitive to the touch.  Like if she barely scratches herself she turns red in that area, I mean you could write a word with your finger and it comes up on her skin.  I've been completely faithful other than this 10 second indiscretion, but I want your opinion, should I be concerned?  Thanks for your time.

[Edward W Hook, MD]

The exposure that you describe is very low, if not no risk.  HIV transmission during oral sex is very inefficient.  Studies suggest that the risk of getting HIV from receipt of oral sex, if your partner was infected, are less than 1 in 10,000.  and many experts feel this estimate is too high.  In fact some experts have said there is no risk for HIV form receipt of oral sex from an infected partner.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  This includes by all of the people who had gum disease, etc.  Thus I can say with great confidence that there is virtually no risk of HIV from the exposure you describe.

As for your spot and your partner's recent difficulties, I suspect they are simply coincidence rather than due to HIV.  The rashes of HIV occur in advanced disease, not recently acquired infection.  As for your fiancé’s problems, in most cases of hives and related sensitivity to touch, these are common problems which, as her doctor has told her, are typically related to viral infections of one sort or another.  The cause of such reactions rarely become apparent and are usually something that just need to be waited out.

If you wish to put your concerns completely to rest, you can go get an HIV test.  this will prove that you did not get HIV from the encounter you describe.

Hope this helps.  EWH

[Edward W Hook, MD]

Clearly if I do not think you have HIV I do not think you would have given it to her.  The viruses I spoke of were community acquired, non-HIV viruses.  As I said, which viruses rarely becomes apparent.  This would thus not be HIV. EWH

[worriedsick1982]

Thank you doctor for the quick response.  You mentioned that my fiance's problems with her skin could be from a viral infection, but just to be clear you would rule out HIV for her symtoms as well, and therefore would be from some other kind of virus?  Sorry to be a nag, just want the clarification.