oral sex - NGU and hiv

Question

Dr. Frascino,

Some time ago two prostitutes in Rio de Janeiro performed oral sex in my penis for like one hour or more. I was drunk.

Five days later I had some pain in my penis. I took medicines and lab results came back some days later negative to chlamidia, gonorrea, etc. Positive only to "coco gram positive". I guess it means I had a NGU.

The problem is I got afraid of hiv infeccion, and the symptoms showed up two weeks after the exposure.

I have had some rednnes in my upper trunk, some faringithis that shows up and goes away. One night I had mialgia, headache and diarrea.

I got an HIV DUO and a RNA-PCR on days 8 and 15. Both came back negative. In Brazil, I can just go to a lab and order any test I want, since I pay for it. It's like US$ 40 the Elisa and US$ 150 the PCR.

The night I had the symptoms was the night before I would get the results from the second PCR.

Well, now it's been two days since I got the result. I was so happy yesterday, bu at night I felt some fatigue and with some pain in my legs. The redness in my upper trunk is still there.

I try not to pay atention on my symptoms, because I'm kind ok paranoid with them.

Anyway I would ask you:

1 - As far as I had only oral sex (even if it was one our long), should I worry about hiv? I have read it is very likely to get NGU in this kind of relation, but not hiv.

2 - I'm sorry Dr. Frascino, but I couldn't avoid taking the PCR and the Elisa 4th generation. Are they, under my circunstances, any good? (I'm ashemed and I know you will blame me, but it's has been a terrible time for me).

Thanks a lot Dr. Frascino. God bless you.

Answer

Hello,

". . . Two prostitutes in Rio de Janeiro performed oral sex 'IN' my penis for like one hour or more."!!!!!???? "Five days later I had some pain in my penis." Well damn, I'm not surprised! They had oral sex in your penis? OUCHAMAGOUCHA! Just how big is that salami of yours anyway?

OK, on to your questions:

  1. The risk of acquiring HIV from insertive oral sex is very low. Many STDs, including urethritis, are much more easily contracted through oral sex than HIV. So, your assumptions are correct.

  2. Any negative HIV test is, of course, encouraging. As far as your HIV-DUO (antibody tests), tests taken prior to the three-month mark are not considered to be definitive or conclusive. The RNA-PCR tests are not recommended for routine HIV screening for a number of reasons, including the rate of false-positives, other technical considerations and cost. So, to date you've run up a lab bill of at least U. S. $380 and unfortunately you still don't have the definitive answer you desire. One can only imagine what that $380 could have done if applied to combating the HIV pandemic or providing crucial services such as HIV/AIDS medication for those in desperate need. But these are decisions you certainly have every right to make.

Do I think you are HIV infected? No. How can you be certain one way or the other? Get a single HIV-antibody test at the three-month mark. It really is just that straightforward.

Good luck.

Dr. Bob