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Giving Oral Sex to Woman Only Risk Factor
Aug 24, 2000

I am living in Indonesia. I gave unprotected oral sex to a HIV status unknown woman in mid July. Contact between my mouth and vaginal fluids was limited, but it did happen. I became very scared immediately thereafter, and have constantly worrying ever since. Ten days later, I tested negative. I had no previous risky episodes. 12 days after the encounter, the woman tested negative. This leaves the 10 weeks or so prior to the encounter in question as far as she goes (assuming 12 week window period for her). During the last five 1/2 weeks since the encounter, I have had following symptoms, not constantly, sometimes coming and going: temp in the mid 99s up to 100; reddishness/sensitive skin around neck, upper chest; feeling discomfort in left hand side of throat; swollen gland in same area; feelings of weakness, tiredness and achiness. Two doctors have said I probably don't have HIV, but can't rule it out completely. The doctor yesterday said my throat looked fine and didn't feel swollen glands. I had another test yesterday, which is just over five weeks after the encounter. I have to wait four days for the results. I am a nervous wreck, I have trouble thinking about anything else. I would be grateful for any insight you can give me.

Response from Mr. Kull

I would agree with your doctor in saying that HIV-infection in your case is unlikely. Your activity was low-risk. There is very little evidence of HIV transmission to a person performing oral sex on a woman (cunnilingus). HIV is more difficult to isolate in cervico-vaginal secretions of infected women than in an infected man's semen. Virus concentration is higher in cervical secretions and menstrual fluids than vaginal fluids (the fluid you come into more contact with during oral sex). It is believed that vaginal fluids dilute the more infectious fluid, decreasing the chances of transmission to someone's mouth. Other factors aside (protective factors in saliva, oral health), this may be why we don't see transmission occurring through cunnilingus.

I understand that you are very stressed. However, if your test is not going to be definitive until three months, why are you getting so frequently in the interim? It hardly seems that testing will "fix" your anxiety. I always try to encourage clients to take care of themselves during the window period. Are there activities you can engage in that relax you? Do relaxation exercises help when the anxiety becomes acute (deep-breathing, meditation)? Are their people or places in your life that provide you with any comfort? Thinking about HIV during this period may only exacerbate your anxiety. If the anxiety persists after your status is confirmed, I would suggest that you consider some type of professional counseling.

RMK



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