China + Unprotected Oral

[Dede649]

Doctor ,



09 August 2008 11h00 morning exposure with young prostitute

6 min unprotected oral before any other contacts ( I did not see any blood or do not recall have cuts or sore to my knowledge on my penis ) no ejaculation

Vaginal sex BIG TIME PROTECTED with Durex condom

then little oral 3 min no ejaculation ( by then sex worker has showered and cleaned mouth )

Vaginal Sex protected

End

Since then I freaked out and still am very anxious

I did the following tests

HIV + Syphilis Anti Reagin ( they said third generation ,  Joint venture American Chinese Hospital , Government Labs ) Elisa Test HV1-2)
One week : negative
44 days ( 23 September 2008 ) :Negative
Gnorrea , Clamydia : 60 days Negative
Syphilis at 90 days : Negative
no herpes visual or pain
No NGU as doctor observation

Here is my list of questions :

1-Do you think I need further HIV testing ( as legal note is 3 months for conclusive tests ) or any further testings of other sorts ?
2-Sida Info services  ( French  Aids prevention services ) stated me that 99,8% people got infected in first month , 25  days average seroconvertion , is it truth ?
3-What do you think about the 44 days negative test ? is is conclusive ? what is the % of reliability of that test at that time ?
4-Why do you state 1 in 10000 exposures what kid of mathematic or case study do you use for such figures ?
5-Do you have informations on China HIV rates compare to Thailand or else ?
6-San Francisco city Clinic is stating a no risk for received oral on std chart ? what do you think about this ? see web  http://www.sfcityclinic.org/stdbasics/stdchart.asp
7-Do you believe Chinese Gov Labs use third gen tests ? or less.
8-I know that we need an infected partner + blood + cut to transmit virus , did it ever happened have you ever read any medical litterature about that ?
9-Bottom line what is the real risk on my case
10-do I need further testing ?

Looking forward to your answers.

Best Regards

[Edward W Hook, MD]

Your exposures were relatively low risk.  As I understand it, your vaginal sex was protected, therefore safe and oral sex is very low risk for HIV and low risk for STD.  On to your specific questions:

1.  You had a negative HIV test at 44 days (7 weeks).  At this time, over 95% of HIV infections acquired at an exposure 6 weeks before would be detectable. Thus while not 100% sure as a laboratory test, when considered in the context of your relatively low risk exposure, you can be confident that you do not have HIV.  I would not get further testing.
2.  they are about right.  We find that well over 50% of people seroconvert within 14 days.  Our data would suggest that the 1 month figure is a bit optimistic.  We feel that at 1 month about 90% have seroconverted.
3.  See above
4.  Our transmission risk estimates are widely accepted figures based on interpretation and study of many studies conducted worldwide.  Not a single study.
5.  No idea
6.  We are a little more conservative than the SF website but we all agree that receipt of oral sex is very, very low risk.  No risk just seems a bit too optimistic.  someone, somewhere may have gotten HIV through an exclusively oral exposure but, In general, it is not something to worry about.
7.  Sorry no data about Chinese government tests or test performance in China
8.  Your question is unclear
9.  Very, very low.
10.  I do not think you need further testing
EWH

[Dede649]

Thanks Doctor ,

will do a final test and that will end all of it I hope

Kind Regards

[Edward W Hook, MD]

1.  Your are far to anxious.  If you want me to say very low risk I will.
2.  Read the answer.  All of those sources are involved.   There has never been a meeting soley on the risk of oral transmission but ithas been discussed regularly (and no, there are no transcripts and I will not supply references)

Yes, it is past time for you to move on.  End of discussion.

EWH

[Dede649]

Doctor ,

Thanks for feedback.

1-Why do you say relatively low risk ? when most of the time you say very very low risk ?
8-Clarification on question 8 : meaning have you had any medical literature , meetings , colleagues ,mentioning a transmission via oral received ?
What I mean is that in theory we need infected subject + blood in mouth + open cut on penis to facilitate a transmission.

So my 44 days test is enough and I can move on now , correct ?

Looking forward to hear from you.