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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17976
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I had just a little over thirty hours ago. I received oral

Customer Question

I had just a little over thirty hours ago. I received oral sex without a condom, but used a condom when penetrating. Can I get HIV, and how soon can I get tested?
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. D. Love replied 11 months ago.
Hello from JustAnswer.Do you mean that you engaged in unprotected oral sex and protected penile-vaginal sex?Do you know the HIV status of the partner?
Customer: replied 11 months ago.
Yes. And no I don't know the status of the other person
Customer: replied 11 months ago.
Are you still there?
Expert:  Dr. D. Love replied 11 months ago.
Yes, I am here and typing an answer, but there are several pertinent pieces of information, so please be patient.
Expert:  Dr. D. Love replied 11 months ago.
First, yes, thre is a risk of contracting HIV from this exposure, although the overall risk is lower than what most people would think. Obviously, if the partner is HIV negative, then there would be no risk. The risk would only be present if she is HIV positive. Oral sex is much safer than penile-vaginal sex or anal sex. The exact risk is difficult to quantify, because it is rarely the sole method of intercourse, but the average risk to a male receiving unprotected oral sex from an untreated HIV positive partner appears to be about 0.005% or less, which means that at least 99.995% of men do not become infected. The risk for penile-vaginal sex is easier to quantify, because many couples will only engage in penile-vaginal sex, so identifying risk over long periods of time will allow for calculation of the risk of a single encounter. The average risk to a male of a single encounter of protected penile-vaginal sex with an untreated HIV positive woman is about 0.004%. As you can see, the risk of unprotected oral sex is about the same as the risk of protected penile-vaginal sex. Since the odds are greater that this partner is HIV negative, your actual risk would need to be adjusted for the prevalence of HIV in your community. In addition, the above risks are for a partner that is untreated. There is good evidence that treating HIV and lowering the viral load will also lower the risk. So if she is HIV positive and being treated, the risk would be lower. Therefore, yes, there is some risk for contracting HIV, but the percentages above are the worst case scenario (she is positive and not being treated), but the actual risk is likely much lower, depending upon the prevalence of HIV in yur community. As for testing, the current recommendations are that there is no need to check an HIV test after every encounter with someone of unknown HIV status. Instead, the recommendation is that everyone that is sexually active should be tested regularly. Annual testing is appropriate for most people, but the frequency of testing can be adjusted according to the sexual history, such as the number of different sexual partners. If someone is anxious and wants to be tested, then it would be OK to perform testing similar to a more worrisome encounter. In the setting of a higher risk encounter, the recommended testing is to perform a fourth generation antibody/antigen test at 4 weeks and again at 12 weeks/3 months. The majority of people will be detected by the testing at 4 weeks, but some will take longer, so the repeat test is done to be certain to find 100% of individuals. There is another test that can be done sooner, an RNA test that looks directly for the virus. This test will usually be positive within a couple weeks after an exposure. However, this test is not perfect. It is about 99% accurate, and it is actually more likely to give a false positive than a false negative. If it gives a false positive result, there is no test that can be done to identify that it is false until the fourth generation antibody test at 3 months, so these people can be very anxious until it is confirmed that they are negative. For this reason, it is not recommended to use this test for routine screening to diagnose whether HIV has been transmitted. There are some people that want the quickest test and are willing to accept the risk of false results, but that can only be the decision of the individual. Therefore, yes, there is a chance you could be infected. The risk is at a level that testing after such an encounter is not recommended, but if you are anxious and want to be tested, the recommended testing schedule would be a fourth generation antibody/antigen test at 4 weeks and 12 weeks. If I can provide any additional information, please let me know.
Customer: replied 11 months ago.
So there's no need for me to get tested?
Expert:  Dr. D. Love replied 11 months ago.
Not for this encounter. As I said above, everyone that is sexually active should get tested regularly, but there is no need to be tested after each encounter with someone of unknown HIV status. If you have an encounter in the future with someone that is HIV positive, then there are other considerations, including whether to take medicine to prevent infection, and testing would be recommended after that encounter. But there is no need to be tested after an encounter with someone of unknown HIV status.
Customer: replied 11 months ago.
I also had a HIV test that was negative about two weeks ago, does that reduce my risk?
Expert:  Dr. D. Love replied 11 months ago.
No. That is only a reflection of previous sexual encounters. If you were also tested for other STIs and were negative, that is good, since several other STIs can increase the risk for transmission of HIV, but the risks noted above are the risk for men in which no other STIs are present.
Customer: replied 11 months ago.
So I should get an STI test?
Expert:  Dr. D. Love replied 11 months ago.
Not because of this encounter. But it is appropriate for everyone that is sexually active to be regularly checked for all STIs.
Customer: replied 11 months ago.
So would you say I don't have much to worry about based on this encounter?
Expert:  Dr. D. Love replied 11 months ago.
Correct. This is about as safe an encounter as you can have if you decide to be sexually active. Obviously, being abstinent would be safer, but if you decide to be sexually active (as most people do), then this is about as safe as you can be.
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17976
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Dr. D. Love and 3 other Medical Specialists are ready to help you
Customer: replied 11 months ago.
Ok, thank you. I'll request you again if I have anymore questions.
Customer: replied 11 months ago.
One last question, can I do anything just in case. I heard there's a medication you can take that can be used 72 hours after.
Expert:  Dr. D. Love replied 11 months ago.
It is the medicines that I noted above for encounters with an HIV positive partner, but it is not used for protected encounters with a partner of unknown HIV status.
Customer: replied 11 months ago.
The situation I'm referring to happened in Nigeria. That's where I'm from. I'm not particularly sexually active, only do it twice a year. Does this affect your assessment at all?
Expert:  Dr. D. Love replied 11 months ago.
No
Customer: replied 11 months ago.
So I shouldn't use the medication?
Expert:  Dr. D. Love replied 11 months ago.
No.
Customer: replied 11 months ago.
Ok, thank you.
Expert:  Dr. D. Love replied 11 months ago.
You are welcome.
Customer: replied 11 months ago.
About the unprotected oral sex, I was the one receiving not giving, does that reduce the risk?
Expert:  Dr. D. Love replied 11 months ago.
You said that above.
Customer: replied 11 months ago.
Hi, it's me again. Just to be clear cause the window is closing, I should not take the PEP medication at all?
Customer: replied 11 months ago.
I'm a very nervous/worrisome person that's why I keep on asking.
Expert:  Dr. D. Love replied 11 months ago.
Correct, PEP is not indicated in this situation.
Customer: replied 11 months ago.
Would it be unsafe to try it. Would a doctor give it to me if I asked?
Expert:  Dr. D. Love replied 11 months ago.
You can ask, but doctors typically would not give it when it is not indicated because of concern of inducing resistant forms of the virus if the drugs are used indiscriminately.
Customer: replied 11 months ago.
So I should just let this go and stop worrying?
Expert:  Dr. D. Love replied 11 months ago.
Yes
Customer: replied 11 months ago.
Last question, is acute HIV curable?
Expert:  Dr. D. Love replied 11 months ago.
No form of HIV is curable. Treatment and control, yes. Cure, no.
Customer: replied 11 months ago.
Ok, thank you
Expert:  Dr. D. Love replied 11 months ago.
You are welcome.
Customer: replied 11 months ago.
Sorry last question. So what your saying is I most likely don't have HIV.
Expert:  Dr. D. Love replied 11 months ago.
What did I say was the risk in this situation?
Customer: replied 11 months ago.
Unprotected oral sex
Expert:  Dr. D. Love replied 11 months ago.
What did I say was the numeric risk in this situation?
Customer: replied 11 months ago.
0.005%
Expert:  Dr. D. Love replied 11 months ago.
Doesn't that answer your last question?
Customer: replied 11 months ago.
That would mean its highly unlikely, right?
Expert:  Dr. D. Love replied 11 months ago.
That would depend on the risk that you consider highly unlikely.
Customer: replied 11 months ago.
Ok, thank you. Sorry to bother you so much.
Expert:  Dr. D. Love replied 11 months ago.
You are welcome.
Customer: replied 11 months ago.
Can you get HIV through saliva?
Expert:  Dr. D. Love replied 11 months ago.
Not really, as kissing does not transmit infection. The risk of oral sex is thought to be due to rubbing the inside of the mouth that causes a small amount of bleeding.
Customer: replied 11 months ago.
How soon can you start to show symptoms?
Expert:  Dr. D. Love replied 11 months ago.
Symptoms of HIV typically start about 2-4 weeks after exposure.
Customer: replied 11 months ago.
Any illness before two weeks can't be because of HIV?
Expert:  Dr. D. Love replied 11 months ago.
You need to quick worrying about clinical scenarios that have not yet happened.
Customer: replied 11 months ago.
Are chest pains a symptom of HIV?
Expert:  Dr. D. Love replied 11 months ago.
You need to quick worrying about clinical scenarios that have not yet happened.
Customer: replied 11 months ago.
I really need an answer, my mouth has been dry for the past few days. Yesterday the left side of my chest started to ache. The pain has gone But now my chest is irritating me and I can't sleep. There's no rash but I feel like this is what happens before it comes. Should I be worried.
Expert:  Dr. D. Love replied 11 months ago.
No, you are only a week after the encounter. Your anxiety is causing you to have symptoms, and the more you learn about what symptoms to fear, then it becomes easier for your mind to create those symptoms.
Customer: replied 11 months ago.
So if I stop thinking about it, will it go away?
Expert:  Dr. D. Love replied 11 months ago.
You need to stop being anxious, which includes stopping thinking about it.
Customer: replied 11 months ago.
So I can't have any symptoms 1 week in.
Expert:  Dr. D. Love replied 11 months ago.
What did I just say? Another part of not being anxious is that you do not need to ask the same question again using different words.
Customer: replied 11 months ago.
Would you advice I do the RNA test?
Expert:  Dr. D. Love replied 11 months ago.
I discussed that above.
Customer: replied 11 months ago.
Yes, but would personally advise I do it for this situation?
Expert:  Dr. D. Love replied 11 months ago.
Another part of not being anxious is that you do not need to ask the same question again using different words.
Customer: replied 11 months ago.
I don't have any rashes and I don't feel sick. So why is my body hot and irritating?
Customer: replied 11 months ago.
And I keep on having dry mouth every time I lay down.
Customer: replied 11 months ago.
I keep on feeling like my skin is gonna break out in a rash, every time I wake up.
Expert:  Dr. D. Love replied 11 months ago.
That is a separate issue and would need to be posted as a new question. If you would like to direct it to me, it can be done through my profile at www.justanswer.com/medical/expert-DrDLove/
Customer: replied 11 months ago.
What are the symptoms I need to look out for? Is a an unexplained cut one them
Expert:  Dr. D. Love replied 11 months ago.
You need to respond in your other thread.
Customer: replied 11 months ago.
What other thread?
Expert:  Dr. D. Love replied 11 months ago.
You posted a new question over an hour ago and you need to respond in that thread.

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