by Rajan Gupta

In reproducing the e-mails I receive, I have suppressed all information that could lead to identification of the person. Sometimes the language used by those asking for help is crude, however I feel it is important to convey the message in the original language of the speaker. So I have made minimal edits.

Due to anxiety and guilt I am writing the mail. Plz help me I am a male 28 yr old unmarried professioanl. I had an affair with a single girl. On one occasion we got time together alone in a room. We ended in bed. This was my first encounter with a girl. She did unprotected oral sex on me. I was inserter and she was reciever. I did not indulge in vaginal or anal sex . This happend on may 2003. I can say this kind of situation happened because since 7 years I am living away from my family and a search for a company ended me up in this relation. AFTER the incident I felt guilt and remembered about HIV infection. From that day i am suffering from mental depression. For a job in a company I had undergone HIV test on July 15 (after 2 months) and test reuslts went to company and I dont know the result. But company offered me the job so I guess test result would have been negative. On Sep 2003 (after 4 months of incident) I had once bleeding through stool. I also had slight constipation since 4 yrs and looks like constipation is increasing. I undergone a test (sigmidoscopy) and test showed normal result. Again bleeding occured and second time some other docotor did sigmidocscopy test and test result was (initial stage of internal bleeding hemorroids). Due to some strange reason the girl left me and got married with another guy on Dec 2003. I am not sure but as far as I know she never indulged in sex with anyone and she had smootches early with one guy. She had mouth sores. She is married and living now. My problem is whether I need to get tested again for HIV? Bleeding from stool killed me with fear of HIV. I am unable to work properly and my productivity is affected due to this. Please help me how do i proceed with my life I am already punised with my depression since 1 year. I am unable to share this with any one.(09/08/04)

Reply (1) The result of the test done by your company was almost certainly negative otherwise they would have counseled you. Also, the risk of HIV from oral sex is very very low. So you should feel satisfied and happy and accept this good result that you do not have HIV. The problem you are facing is irrational fear based on blood in your stools and the resulting mental stress is affecting your life. Such fear is very common, especially when it brings up the possibility of HIV, and needs to be addressed. So let me clarify some issues. Blood in stools can be from many possible causes and not HIV. It seems that another concern you have is the sores on the girl's mouth. These too can be due to other causes, many completely normal or may be due to Hepres.

Regarding bleeding from the anus or the possibilty of sores on the surface of the anus you should go see a skin and Venereal Disease doctor.

As regards the fear and mental stress, my recommendation is to go and have another test done at a good center that provides good pre and post test counseling. They, and the results of the second test, will help you overcome the fear.

Followup (1) (5 April 2005) I wrote to you an earlier email with my hiv scare.

Almost 2 years back I recieved unprotected oral sex from a lady. I did not think that it was a risky affair. After the incident I just studied about HIV from Internet and was I scared about probable infection. My life changed after that. I was scared to test my hiv and I was living away from family. My productivity at work decreased. I developed fever and other stomach deseases. Severe constipation started and it ended up in bleeding piles. I am always under medication since 1 year.

Later I came to know that risk of oral reciever is too low. Then I went for an hiv test and my hiv was negative.

I am back to life again. I am thankful for you to take time and write a reply to me when I was alone in my life.

  • Dear doctor, 3 weeks before i had sexual intercouse with a sex worker with 2 condoms on my penis within one minute my semen cameout. i don't know the brand and the quality of the condoms which she supplied me. condoms did't break. I used the condoms from start to end. intercourse lasted less then one minute. what are the chances of getting STD. Should i get tested for HIV/STD's. if so when. PLS. ADVISE (02/01/05)

  • Reply (1) The chances of HIV infection from what you describe are very very small. Please get a test done 3 months after the date of sex with sex worker if you are concerned. Mental tension/stress as a result of such risky behavior is a very serious problem and it can really affect your life -- so please avoid such contact. Condoms dont fully protect against some kinds of STD that can be transmitted via skin contact -- skin that is not covered by the condom. Examples are herpes, HPV. If you observe little pimples (that are painful but go away in a week or two) or warts (skin growth) in the genital area -- please see a skin and VD specialist. Having sex with a sex worker has a very high risk for STDs and HIV. Please try to minimize your risk by not having sex with sex workers or at least using condoms of good quality.

    Followup (1) How long does it take to get the symtoms for herpes, HPV & are these as dangours as HIV. what are the health risks.

    REPLY (2) For information on STDs search through google for Herpes and HPV (WHO and CDC websites have very good information). These infections are not life threatening -- they just make your sex life uncomfortable and stay with you for the rest of your life, erupting when your immune system is weakened by flu or other causes. The main concern these days is the increased risk of HIV infection if you have other STDs.

    Follow UP (2): As you wrote to me that the risk of HIV is very very low in the first line & later you have mentioned that having sex with a sex worker has a very high risk for STDs and HIV could you please clerify me regarding this issues. As you might have guessed I am living/working in Saudi Arabia where every thing is prohibited. does 2 condoms provide better protection then one. and or there case where you get infected by HIV even with 2 condoms. As per my observation there was no leak/tear in the condoms before and after sex. please advise me.

    Reply (3): There is no contradiction. Sex with a sex worker is very high risk if you do not use a condom or it tears. So in general you put yourself at very high risk every time you have sex with a sex worker In the specific incident you mentioned you used 2 condoms and they did not tear. So in that case the risk became very very low. Risk changes by the specifics of each situation and what actually happens. Using one condom of good quality and properly is adequate. Two condoms also work, and if put on properly, provide a little more protection in case of tear but from what I hear are not as comfortable. I did not know you were in SA -- I thought sex work was prohibited there. Can you very kindly educate me how the sex industry works there? Or did you have sex while on travel outside SA?

    Follow UP (3): Thanks for sparing time for me & replying for my emails. i was in Dubai for a business visit when this incidence happened. There are lot of females coming from East Europe to Dubai and working as sex workers. Sex work is prohibited in Soudi Arabia. Women wear veil (black dress) and it is hard to even see the face of lady/women in KSA which follows strictly islamic law. This is my first ever encounter and shall be the last also. i am getting married soon. so pls. advise me should i get married or not.

    Reply (4): By all means get married. But before getting married or having sex with anyone else, and this is for your safety and the safety of your wife to be, please get tested for HIV and other STDs so that you can begin the relationship with a clean slate and without fear of past activities.

  • Hello Mr Rajan, I am a 23 year old guy and was in a physical relationship (oral sex) with another guy from my college. This lead to my discovering that I had alternate sexual preferances (I am bisexual). More than the sex, I was really fond of this boy as a person. Suddenly he left me for another girl without giving any suitable reason to me. I was really depressed by all this and the hangover of this depression along with some other factors made me to quit the job that I had got after completing college. In this frustration, in the pursuit of some pleasure I made out with another guy whom i got to know through chatting. He seemed to be an old player and had a condom with him. But before I remembered to ask him to wear it he had already made contact with his penis to areas near my anus. In the course of sex, i could not allow him to penetrate me completely as it was the first time I was trying anal sex and so! ! ! it was very painful for me. He did not ejaculate inside me because of this, but his condom got torn while taking out his penis. After the entire event I am really scared of HIV....really terrified by the possibility of my having contracted the virus. I asked him later and he told me that 99% of the times he had been safe but would also get himself tested soon. I happened to read that the virus is carried in the pre-semen and not in the semen and this has really scared me all the more. Is it possible that i may have also got it? Do you recommend a test? Is there something called a window period for which I should wait before getting the test done? If you do recommend a test, please also let me know of some reliable place in bangalore where i can get it done as i stay there, and approximayely how much will the test cost? Please help me get over my fear.... Waiting for your reply...(VD 02/18/04)

  • Reply: From what you write the chances of infection are very small. However, the first step in overcoming fear is to get tested. In Bangalore Freedom Foundation provides anonymous HIV testing or can direct you to a very good and reliable place for testing and counseling. This service should be free.

    Window period is the time between when the virus first enters your body (through risky sex or blood contact with an HIV infected person) and when your body produces enough anti-bodies in response in your system to be detected by the test. We generally advise a person to wait 3-4 months after possible exposure to HIV to get tested. The reason is that if the results of a test done after the window period is negative then that negative is confirmatory. Test done during the window period sometimes miss detecting the virus if there isn't enough of it present. If your choose to wait for the window period to pass then during this time (or between the time of the test and getting its result even after the window period) do not have sex with anyone (your partner or anyone else) to prevent spreading the infection just in case you did get infected.

    For future, learn more about HIV/AIDS, precautions, and how to develop healthy and safer sexual practices (read the Q&A from students on the my website). For people who are prone to fear as a result of guilt or concern for their health, the only safe way is to not have sex with unknown people and especially people whose HIV status is not known to you. Not knowing their HIV status does not mean they are not infected -- only a HIV test can determine the status and not how a person looks or feels. Good luck

    Follow UP (1): As suggested by you I waited for around 3 months and got the Elisa test done which came negative. I did not engage in any sexual practice also after that. Now the Problem is that I waited only 86 days instead of 90 days, as I am joining a new job shotly. The first doctor said that this much time as window period was sufficient. But after collecting the report I had to consult a different doctor today who said that 86 days is not enough and asked me to repeat the test after 2 weeks. Is it absolutely necessary for me to undergo the test again, or are 86 days enough?

    Reply (1): I dont think it is necessary for you to get retested as 86 days are sufficient for 99% confidence level report. Also the risk as described by you was very low. It is now more an issue of fear and peace of mind. So if the uncertainty of window period still bothers you, please go and get the test done again - it will help you forget this unhappy experience! Most important point is not to have risky sex in the future.

    Follow UP (2): Thank you for all the guidance. I have got the 2nd elisa test done and by God's grace it has come negative. Now, I shall take care that I do not indulge in reckless sexual behaviour again.

  • Sir, four months back i had an unsafe sex. After one month i got heavy fever and head ache and it lasted for one week. My wife is pregnant and she had a HIV test negative. Sir, please give me suggestion if I should under go an HIV test.(JD 03/21/04)

  • Your wife's test being negative does not tell anything about your HIV status. HIV does not have obvious and distinctive symptoms at early stages, so your description of having had the flu one month after unsafe sex does not provide any diagnostic information. Because you had unsafe sex, I would defininately advise you taking the test for at least two very important reasons

  • I am in deep trouble. Two and a half months ago I had an encounter with a lady. Though I did not penetrate into her vagina but kissed her breasts and lips. I ejaculated on her thigh. Is there any chances to get infected with HIV. Please advice and also advice on testing about AIDS in Delhi. (RK 4/03/03)

  • From what you write and describe, there does NOT seem to be risk of HIV infection. On the other hand your fear and concern about your well-being is very real and I imagine, even after this long period, still causing you a lot of unhappiness and tension. Such fear and emotional trauma is, unfortunately, one of the very ugly after effects of risky sex. The only way to make sure you do not have HIV infection is to get the HIV blood test done. For HIV/STD testing and counseling in Delhi, two places I know are the HIV counseling center in Ram Monohar Lohia hospital and All India Institute of Medical Sciences. In addition to the test see a counselor. He/sh can help you get over this worry and if all works out well -- promise yourself not to get into such a mess again. As you have seen a short lived pleasure can produce a very serious long term emotional trauma.

  • Sir, I want to know how are the chances for a person to acquire AIDS by licking the veginal area of the girl friend whose background was liberal(had many boy friends at past).- (NB 02/23/02)

  • The chance of getting HIV from oral contact with your girl-friend's vagina are small. The probability that you acquired infection by licking, if that is all you did, is very very small. However, the only way to be sure is to get an HIV test done. This is a specific blood test and available in good hospitals throughout India. So, if you are troubled by doubt then you should get tested. Before getting the test, you should wait for about four months after the incident so that your body has had sufficient time to build up an antibody response. The reason why we recommend this wait is that the tests commonly done are based on reaction of test chemicals with antibodies to HIV, and these take time to develop in sufficient numbers.

    In addition to HIV, there are other sexually transmitted diseases like herpes that spread more easily by oral contact. You should get tested for herpes in case you get blisters on your mouth.

    In future you should build confidence in your relationship with your girl-friend (understand each other, know each other, be able to discuss issues of sex and sexually transmitted diseases) so that you do not have such emotional trauma after hasty action.

  • I have one query about HIV infection. A couple of days back there was "MUNDAN" ceremony of my kid who is 1 year old, in which all of his hair on his head are removed as a part of religious ritual. During this there was some bleeding on his head. The blade used was brand new but after removing all the hairs the barber rubbed a piece of used alum (Which is used for water purification and widely used as anticeptic in barbar shops in india). Is there any possiblity of transmission of HIV to my kid. Please guide. (GG 12/18/01)

  • To the best of my understanding, alum (potassium aluminium sulphate) is used in such circumstances because it is a coagalant. This, in principal, means that it can lead to blood contact and thus transmission of blood borne germs. However, since the mundan ceremony takes a while, it is very likely that barber would not have used that same piece of alum for a few hours before using it on your son and may have washed it in between customers. So, I believe, the risk in this case is minimal and I would not worry.

    If you want to be completely sure, and for your peace of mind, then my recommendation is to have your son tested at a reputable hospital/center 4-6 months after the incident (to give sufficient time for the anti-body response to build up -- the ELIZA test used in almost all centers reacts to anti-bodies to HIV and not to the virus).

    Meanwhile, please spread awarenness amongst friends and relatives to avoid such traditional ways where barbers, ear cleaners, ear/nose piecers are allowed to use their own instruments which may not be properly sterilized between every new customer. Even more than the risk of infection, the mental trauma to parents, as experienced by you, is very intense and its impact on the family should not be ignored. As you report, in your case it was not the cost of providing all new equipment to the barber that you failed in, but in not thinking about the alum part. Such oversight is common and awareness on all such small things is hard to spread and maintain. The best approach is to ask the barber for all that will be needed, provide all the stuff yourself, and make clear to the barber that they are not to use any stuff of their own even if it may have been missed in the list and not available immediately (a little bleeding is far more acceptable than the possibility of infection).

  • i fuked a prostitute,without condom now i afraid not to get inficted of aids. i asked her that she is sufring from aids or not she refused. while having sex there was no bleeding or cut in either of us. i did first time .tell me what to do and how will i come to know that i am inficted or not. (AR 10/30/01)

  • The best and only way to know if you have been infected is to wait for 3-4 months after the date of sex with the prostitute and then get a blood test for HIV done at a good hospital or voluntary testing center.

    Meanwhile please do not have sex with prostitutes as the chances they have HIV is very high. Also, until your HIV status is resolved by the blood test, do not have sex with anyone else in case you are infected. This is to prevent transmitting the disease to another person like you.

    In most cases of HIV infection, and especially in the acute and chronic phases (first few months to first few years), there are no outward symptoms like bleeding, cuts, rash, or sores on a person that will warn you of a person's HIV status. If you must have sex with people whose sexual history you do not know, learn to use a condom beforehand, and use a good quality, new condom for each and every sex act.

    Back to my home page for information on HIV/AIDS

    Back to main page for questions/answers on HIV/AIDS

    Rajan Gupta