Gave oral to HIV positive

[anonnn]

I gave oral to a man 8 weeks ago and swallowed.  I later found out that he was HIV+.  I have pretty good oral health, but I do have oral herpes.  I tested negative 29 days post exposure with an oraquick test using blood.  I have not had swollen lymph nodes, but have had a weird aching pain coming from their general areas.  What are the chances I have contracted HIV?

[jkinatl2]

Giving oral is considered extremely low risk, bordering on theoretical. If your HIv positive friend was on meds and his viral load was undetectable, the risk really sinks to negligible.

In addition, saliva contains over a dozen different enzymes and proteins which de-activate the virus.

Your test at 29 days was, of course, not conclusive. But many if not most infections are detected within that time. I would be very surprised if you were to test positive over this event.

Other STD's, of course, can be easily transmitted through oral sex.

[Andy Velez]

Like JK I view yours as a "theoretical" risk. In addition to what he has said, longterm studies of sero-discordant couples who have had lots of mutual oral and only protected vaginal/anal intercourse have resulted in not a single new infection among sero-negative partners.

You can re-test if you want to for your own peace of mind at 6 or 13 weeks. I expect you to continue to test negative.

[anonnn]

Have you guys ever heard of anyone contracting it this way?  What about the weird achy feeling in my groin and other lymph node sights?  I was tested for all other STDs as well and those came back negative.  I don't think I ever got a fever this whole time, but I am so scared.

[anonnn]

And he said he was on meds and had been for a year and his viral load was undetectable, but then again he lied about being positive, so I don't know what to believe

[Andy Velez]

Those "symptoms" mean nothing as they are not in anyway HIV specific.

Listen, you're at 8 weeks post the incident now. Since you are obviously anxious about it, get tested. I certainly expect you will test negative. I suggest this only for your peace of mind so you can put the issue to rest. Ordinarily we recommend testing at 13 weeks, but in this case since it was only a theoretical risk, you can test now.

And I am only suggesting it for peace of mind and not because I think you really had a risk.

[anonnn]

I dont think that would help because I wouldn't feel safe until a 13th week negative.  I have a question about Dr. Bob and thebody.com.  He wrote in a response to an oral sex question that he has "well documented cases" of HIV transmission for the person giving head.  I wrote the question to him as well, but have you ever heard of these "well documented cases"?  Has anyone on here ever heard of being infected this way? 

[jkinatl2]

I dont think that would help because I wouldn't feel safe until a 13th week negative.  I have a question about Dr. Bob and thebody.com.  He wrote in a response to an oral sex question that he has "well documented cases" of HIV transmission for the person giving head.  I wrote the question to him as well, but have you ever heard of these "well documented cases"?  Has anyone on here ever heard of being infected this way? 

I honestly cannot point to a study which offers a "well documented" case of oral transmission which does not rely on patient report. And patient report is notoriously unreliable.

The most reliable studies I have read have been tracking sero-discordant patients over time, who used condoms for anal and vaginal sex, but not for oral. In three studies spanning hundreds of patients and over a dozen years, not a single case of oral transmission was documented. These studies are, I think, much more reliable because they skew towards skepticism rather than belief.

[anonnn]

What is your guys' opinion of this:

Found on: http://www.poz.com/articles/348_2126.shtml

There have been three case reports and a few studies suggesting that some people have been infected with HIV as a result of unprotected oral sex. However, these case reports and studies all involved men who were the receptive partners (the person doing the "sucking") during unprotected oral sex with another HIV-positive man. There haven't been any case reports or studies documenting HIV infection among female receptive partners during unprotected oral sex. Even more importantly, there hasn't been a single documented case of HIV transmission to an insertive partner (the person being "sucked") during unprotected oral sex, either among MSM, or heterosexuals.

Thats from this same website.

[Ann]

anon,

The studies cited in that article are based on the "patient report" model that JK mentioned above. They're not reliable.

The studies that ARE reliable are those serodiscordant couple studies where the couples were studied over many years. They weren't just asked how they believed they were infected, as in the patient report studies.

There have been three long-term studies of couples where one is positive and one is negative. In the couples who used condoms for anal or vaginal intercourse, but no barrier for oral activities, not one of the negative partners became infected with hiv. Not one.

Ann

[anonnn]

So if I tested positive, would my case just be an extremely rare case, or would everyone who considers oral sex to be NO RISK say that I must have done something riskier

[Andy Velez]

Listen, we're not going to continue to debate this back and forth with you. You've already had carefully considered responses. You can relieve some of your anxiety by getting tested now and collecting what we fully expect will be a negative result.

OR

You can continue speculating and guessing and worrying and surfing the next until 13 weeks and THEN collect the negative result.

Whichever you choose I can tell that we're not going to continue indulging you in this totally fruitless kind of speculation when none of us consider that you have had a genuine risk. Right now all you are doing is fueling your fears when getting tested would let you know how unfounded  they are.

[anonnn]

K, I plan on getting tested tomorrow.  2 more questions.  If I get a duo test, will it be conclusive at 8 weeks?  Also, the thing that is so worrying to me is the groin pain.  I had a nurse practitioner tell me that none of my lymph nodes are swollen, but there is still pain.  It started about 4 weeks after the incident and has continued until now.  My question is if you get HIV, can your lymph nodes react by becoming painful WITHOUT swelling?  Also, I just got a canker sore on my tongue this morning.  Anything on that would be appreciated.  Thank you very much for your time and consideration.

[anonnn]

I got my 62 day post exposure oraquick test.  Result was negative.  Very relieved about that.  How sure would you guys be of a conclusive negative?

[Ann]

anon,

It's no surprise you tested negative. Your risk was strictly theoretical. You can test again at three months if you want, but don't expect a different result.

The vast majority of people who have actually been infected will seroconvert and test positive by six weeks. Where there has been an true risk, a six week negative should be confirmed at the three month point. You did not have a real risk.

Ann