HIV from Anilingus???

Question

Hi Dr. Frascino, I just found this site and think its one of the best (if not THE best) of its kind on the web! Thank you for everything you're doing!

I'm an otherwise healthy heterosexual male in my late 30's with no known prior exposure to HIV. I "gave" unprotected cunnilingus AND anilingus to a female prostitute about 6 weeks ago, but all other sexual activities were protected. She appeared & smelled very clean, was non-menstruating, without obvious external skin defects, sores, cuts, etc.

3-4 weeks after this encounter, I developed a 99-101 degree fever, body aches/pains, pharyngitis with white tonsillar exudate, lethargy, a bit of diarrhea, and slight, transient submandibular glandular soreness. This lasted about 24 hours, then I felt much better.

What are the chances of contracting HIV from either of these forms of oral sex (especially ANILINGUS) with such a HIGH risk individual?

Also, since I've been VERY scared over the last few weeks, I got the fairly new "HIV-1 RNA Ultrasensitive" viral load test done and it came back "negative" or "undetectable" with a sensitivity down to 50 copies/mL. Does that mean that I'm TRULY NEGATIVE and don't need to get the ELISA antibody test done?

Thank you SO much for your time & consideration!

Answer

Hello,

Oral sex carries a very low risk for HIV transmission. I'll repost a recent question from the archives that addresses the unprotected-cunnilingus question. (I'm reposting archived questions in an attempt to show dear readers that the answers you are looking for are almost always already waiting for you in the archives!)

Regarding anilingus or rimming, there have been no documented cases of getting HIV from rimming or being rimmed. (This information was also in the archives, just in case anyone was wondering.) However, I should also mention hepatitis A, intestinal parasites and herpes can be easily transmitted by rimming without a barrier.

Regarding routine HIV screening, I do not recommend PCR testing due to cost and the possibility of false-positive results. As for your symptoms, remember symptoms do not equal HIV disease. The reason for folks to get HIV tested is that they placed themselves at risk for HIV, not whether or not they develop "symptoms."

Good luck. Stay safe. Stay well.

Dr. Bob