Hello Dr.

Question

I am a gay male and I received oral sex from 2 guys in May and June, 2008. In August, 2008, I was tested for HIV with a rapid test (the result was negative). I also had a Western Blot done because I had fears and my doctor maybe wanted to calm me down, and that was negative too. But the testing was done only about a month or a month and a half after the oral sex. Again, I recieved oral sex. I am very concerned that I could have HIV. When should I be tested again? In 2 months or in 5 months? And what is the risk percentage of getting HIV through getting a BJ? The CDC says there is a risk there. Thank you!

Answer

Hello,

Unprotected oral sex carries only a very low risk for HIV transmission/acquisition, particularly for the insertive partner (the lucky guy getting sucked). That risk, however, while being extremely low, is not completely nonexistent, primarily due to potential extenuating circumstances, such as a concurrent STD, oral trauma, non-intact skin, etc.

Regarding HIV screening, HIV-antibody tests taken prior to the three-month mark are not considered to be definitive or conclusive. For a definitive result, you should repeat your test at the three-month mark (from the last date of potential exposure). I should also point out that I disagree with your doctor's decision to order a Western Blot test. These tests should only be done to confirm a repeatedly reactive (positive) HIV screening antibody test (ELISA, EIA, rapid test, etc.). Western Blot tests can produce false-negative or indeterminate results, which can cause incredible anxiety, particularly when ordered inappropriately (as in your case)! That your rapid test and Western Blot at one month were negative is encouraging, but not conclusive.

The CDC's estimated statistical risk per episode of unprotected insertive oral sex with a partner confirmed to be HIV positive is 0.5 per 10,000 exposures. However, remember this is only an estimated statistical risk and cannot be specifically applied to an individual situation. What you need to know is that your HIV risk was extremely low and if you want a definitive HIV test, you'll need to wait at least three months for the HIV-antibody test to be conclusive.

Good luck.

Dr. Bob