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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19449
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Please give a opinion Dr I have a crippling fear of HIV,

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Please give a opinion Dr

I have a crippling fear of HIV, over many years of sleeping with various women I got tested and was negative. However over the last year every morning and the following days after heavy drinking I become racked with fear that I ve had sex with a hooker. I had a blackout last weekend in a red light district, I was with friends and can remember most of the night apart for the end. My friends said I was going for a cigarette but never returned. I think I got a taxi straight back to the hotel as I was very very drunk but do have a slight memory of this. They returned to the hotel several hour later and I was in bed. I can account for the money I spent to a certain degree, I am scared I may have slept with a hooker and not remembered? It's causing serious sleepless night. I was so drunk am almost certain I would not be able to even get a erection.

Please help
Obviously, we cannot know whether you had sex with someone.
How can we be of assistance?
Are you looking for the level of risk that would be involved if you did have sex with someone?
What information would be helpful to you?

Customer: replied 4 years ago.
Am guessing worst case, I slept with a hooker drunk unprotected. It's a regulated red light area. Am beginning to think this fear OCD related.
I can detail the possible risk assuming the worst case scenario, which is that you did indeed have penetrative sex with an HIV positive woman, regardless of whether she is a hooker. The risk of having sex with a hooker is that there is a greater risk that they are HIV positive, but once positive, the risk would be the same as with any HIV positive female.

The risk to the male of a single act of penile-vaginal sex with an HIV positive woman is lower than most people realize. The average risk of developing HIV for a male from a single episode of unprotected penile-vaginal sex with an HIV positive woman is 0.05%, meaning that 99.95% of men do not develop HIV. The greatest risk would actually be if there was anal penetration, for which the risk to the male would be 0.065%.

Of course, since this risk assumes that she was HIV positive, the overall risk would be lower, unless you know that 100% of the hookers in your community are HIV positive. If it is a regulated area, then that usually includes regular HIV testing, so it is more likely that she was not HIV positive, and the risk would be lower than the average risk of 0.05%.

This also assumes that no protection was used. If a condom had been used, then the risk would be lower. Of course, if you were unable to achieve an erection, then no penetration would have occurred and no risk would be present.

The current recommendation in the US and the UK do not recommend testing after every case of sex with a person of unknown HIV status, but rather that regular testing should be done for all people that are sexually active. This regular testing is most often done on an annual basis, although the frequency can be adjusted based on the level of sexual activity. However, if someone is anxious and desires more frequent testing, the only risk of more frequent testing is the cost involved, and if you are reassured by more frequent testing, it may be worth it to you.

Therefore, with the worst case scenario (anal sex with an HIV positive woman), the risk would be 0.065%, so that it is much more likely that you would not develop HIV (99.935%), and your risk is probably less. Most men are not concerned about this level of risk, but everyone has a different level of risk tolerance. If you would feel better with more frequent testing, that is an individual decision.

If you have any further questions or need clarification, please let me know.

Customer: replied 4 years ago.
Thank you for the information Dr

Am beginning to think that I have a phobia over HIV from years of not knowing my status then testing neg vowing I would never sleep with such women again and go through the agony of waiting for a test result again.

Do you think I may have a mental issue in regards XXXXX XXXXX
Many people of both genders fear developing HIV. The fact that you have such fear is not an issue, by itself. It only becomes an issue if the fear becomes crippling, as you stated in your original question. I cannot know that it is crippling beyond what you tell me, but if it is, in fact, crippling, then it would be considered a mental issue and it would be appropriate to seek counselling to overcome the severity of the fear.

Customer: replied 4 years ago.
Thank you again

I think I may have a mental issue with it and it seems to become a bigger issue when dealing with a hangover and stressing over not being able to remember having sex, always have remember having sex while drinking and also the problems with a erection. However since my neg result I stress that I could have sex and not remember

Would seeing a mental health expert be the correct course of action
Yes, seeing a counsellor would be appropriate to help deal with the crippling fear.

Dr. D. Love and 4 other Medical Specialists are ready to help you
Customer: replied 4 years ago.
By meaning crippling, it's been with me even when I was a virgin, scared of being needle pricked etc, pouring over the internet for HIV symptoms and checking myself, I just wish it would end. Finally knowing I was neg yet thinking every time I went out and had to much to drink and not really remembered the end of the night that I may have had unprotected sex
If you perceive it as crippling, then it is appropriate to seek counselling.