Another story of woe

[Loser66]

Dear Doc
I know you have faced this question multiple times but I think you can appreciate that when it happens you feel its the first person thats ever faced the issue.
Like several posters I had protected sex but unprotected cunnilingus with a working girl. She was ostensibly clean (even showered before sex) and I have no idea about her status other than my paranoia that she is HIV+.  The encounter was 8 days ago and I have been to hell and back with anxiety. In fact if I hadn't read some of your other posts I may have done something desperate by now.  At this moment I intend to get tested in 2 weeks before I return home and am sure that I will descend to the depths before then again. Any symptoms of HIV I have read about have not shown themselves or the ones that have (mainly fatigue and night sweats) I am trying to put down to my anxiety and lack of sleep.
Although what I did was stupid (I am married) would it be even more stupid to not get tested at all? I am in a foreign country and don't feel confident about a doctor maintaing my confidentiality with my company. I am also concerned that a non-english speaking doctor may not get the results to me in a fashion I would understand. Thus, knowing my paranoia, I will just assume that I have HIV.
I cannot really wait to test until I get home as I know my wife will want to resume "relations" immediately and I could not do that if I had any thoughts that I was infected thus an explanation would be in order. I could not wear protection as I have had a vasectomy.
I have read many threads were you talk about "a lightening strike" but I also remember adverts from the UN that talk about the ease of HIV spread. Do you think they are just being alarmist in order to get their good message across about safe sex.

[T-Cat]

Guys, ive been where you both have and out the other side.  Utter hell for time.  24/7 thinking about that ****.
i have 2 words of advice for you:
CHILL OUT.
You dont have HIV man.  Ide be willing to take up a 10 million dollar cyber bet right now that says you dont have HIV, in fact, this may sound strange to you, but im so sure you dont have HIV as a result of that sexual encounter, that ide be willing to eat all the skin my own right arm if you do.
make you feel any better?
The chances are actually far less than the last guy mentioned.  0.7% is the percentage of infected population in the US.  Out of that 0.7% half of them will be gay men, another quarter will be heroin addicts.  From whats left you have straight people, and as an even smaller percentage hiv+ prostitutes.  The chances of infection from a NON PROTECTED spell of intercourse with one of those pr0s is 1 in 1000.
The odds of you getting hiv are the same as me winning the lottery by finding a ticket down a manhole i accidentally fell down.

look man.....  you made a mistake in fukin a pr0.  especially if youre married.  I know you love your wife, so dont lower your own self worth and self esteem by doing a *****.  you dont have to pay for it your wife is more than willing to give it to you for free with love.  you wont make the same mistake again i know, but ffs be sure not to.

[vs7829]

Loser - I am in the same boat as you and it's something we have to deal with - although the fact that you used protection and assuming it didn't fail (unlike my situation where it slipped off when I was removing myself) you have zero chance to catch HIV. In fact the doctor will probably tell you that you would have had zero chance even if you didn't wear protection which is not a comment I totally understand. However, this may ease your mind a bit - in America there are an estimated 2 million people with HIV (probably lower but lets be more conservative than not) with a total population of 296 million. So the chance that you met a girl with HIV is about 0.7% (2,000,000/296,000,000). On top of that according to the doctor there is about a 1 in 1000 chance of acquring HIV through one act of unprotected vaginal sex, hence that would mean the chance you acquired HIV through this encounter would be 0.0007%. Of course your risk is even lowere when you consier you used protection and it did not fail.

I understand your anxiety though - I am going through the same anxiety and even worse - I look at my anaylsis all the time and although it shows I have a very minucle chance of acquiring HIV I still worry about it endlessley - I suspect there hasn't been a minute since the incident that you haven't thaought about it. I'm pretty sure you will be OK - I hope for both of us - good luck!

[H. Hunter Handsfield, M.D.]

You have accurately predicted my response:  the likelihood you acquired HIV from the exposure you describe was very low, even if the woman was HIV infected.  But I think you probably should be tested for peace of mind.  Regardless of language and cultural barrers, the likelihood of not understanding a negative result--which is the almost certain outcome--should be low.  It probably will drive you a bit crazy to "just assume that I have HIV".

I can't speak to the motivations of the UN or anyone else about their HIV prevention advice.  In some settings, HIV is much more common in the general population and/or sex workers than in the US; and the proportion of HIV+ people who have high viral loads and thus are more infectious may be much higher as well.  That's not to say that cunnilingus becomes high risk, but in such circumstances the overall chance of HIV transmission from any particular exposure is elevated compared with similar expposures in North America.  The notion that casual sex with local partners is inherently risky and should be avoided, and/or that condoms be used consistently, is pretty good advice--not just for HIV, but for STD prevention in general.

Good luck--  HHH, MD