[Question #10340] Follow up on 10321

23 months ago

Hi Doctors,

Just writing a follow up question to 10321 in regards to my unprotected oral sex risks with both a known male contact and female csw within the same time period of each other.

I'm about 17 days in from the exposure and no visible symptoms but this is why I'm writing.

While I was writing about most STIs the primary worry of mine would be HIV. I've read enough on here to know it shouldn't have to be the case and testing at six weeks is just to reassure me and not because there's any real risk of catching it.

Whether it's me noticing or being hyper aware of sensations, I have developed night sweats recently around the chest area. So I'm starting to get a little concerned. I have no other symptoms. So does this change your assessment? Adding logical context, I am over weight and have had acid reflux in the past so I'm hoping it's that.

Thanks again !

23 months ago

Also forgot to mention that I'm having these sweats in a relatively cold room.

For the record, I will be getting a full STD panel at six weeks, I just want to know if my last symptoms change your mind on my chances of catching HIV.

I do have to say, it does add an element of stress on having casual sex as a relaxing activity knowing the risks.

Once again, thank you so much for this service and I'm sure it's only human to get a little tested when you have to say the same multiple thing to different people over many years so thank you for showing that compassion all things considering since accurate resources if information are very limited.

H. Hunter Handsfield, MD

23 months ago

Welcome back, but sorry you found it necessary. The bottom line is that this information doesn't change my evaluation or advice.

As I said in your recently closed thread, "there is no measurable risk of HIV" from receiving oral sex (or hand-genital contact). Expanding on that statement, in the 40 years of the known worldwide HIV/AIDS pandemic, there has never been a proved case of HIV transmission oral to penis. Based on how some people believe they were infected -- which often is mistaken -- CDC once calculated a risk of one chance in 20,000 if the oral partner had HIV. That's equivalent to receiving BJs by infected partners once daily for 55 years before catching HIV might be likely. In other words, zero for all practical purposes. This is why I advised that testing for HIV in this circumstance is primarily for reassurance and not because of actual risk; and why it is safe for you to continue unprotected sex with your wife.

And no, having fever (which is the reason for true night sweats) doesn't change my opinion or advice. Fever or night sweats would never be the only symptom of new HIV infection (acute retroviral syndrome or ARS) -- and in any case, ARS symptoms are rarely delayed beyond 8-10 days after exposure.

For reassurance, you should go ahead now with an HIV test, preferably a lab-based AgAb (4th generation) blood test. Although it can take up to 6 weeks to become positive, the result always is positive when symptoms of ARS are present. In other words, although a test now would not prove you didn't catch HIV, it would mean conclusively that HIV isn't the cause of these or any other symptoms you may have going forward. In the meantime, stay mellow. There is no chance you have HIV and I am confident your test (if you do it) will be negative.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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23 months ago

Thanks for the quick response doctor. The last couple of days have been me waking up randomly to find that area slightly damp which is why I panicked a little as I was confident I had no other symptoms and I'm not sure if anxiety took hold as the symptoms match up to the timing.

With that said, you mentioned about receiving but didn't say anything about giving oral sex which had some risks so I was wondering about that as well. Yes, the person says he's healthy but in the small chance he's not does this change your assessment ?

I will use my final follow up to track if anything has changed for me symptom wise.

Thanks again.

H. Hunter Handsfield, MD

23 months ago

Performing oral sex is almost as low risk as receiving it -- consider the risk zero, especially since you are confident your partners don't have HIV. And don't worry about symptoms -- no need to "save" a final comment for that purpose. Symptoms almost never are useful indicators of a new HIV infection, despite all the noice you can find online about it. Even the most typical symptoms of a new HIV infection almost always have other causes. Pay zero attention to any and all symptoms you might have in the next few weeks; they will make no difference in the possibility you have HIV, which is very close to zero.---

23 months ago

I will take your word for it Doctor. You can close the thread and terribly sorry for making you repeat your assessments.

Eternally grateful to you, Nurse Terri and Doctor Hook for continuing to do this for so long.

H. Hunter Handsfield, MD

23 months ago

My last comment about symptoms could have been worded better. The main thing is that symptoms rarely make a difference in judging whether or not someone has HIV. It's not that you should pay no attention to them; that part of my advice was wrong. But it is true that it is quite rare that symptoms are helpful, and so many people go through so much stress worrying about them after an exposure, without need. After a worrisome exposure, it's easy to assume that anything that feels atypical a bad sign. But it almost never is. Much of the time people are just noticing minor things more than they otherwise would.

Truly, don't worry about this. There is no chance you have HIV. (After thousands of questions, it hasn't happened in 20 years of this and our previous forum. You won't be the first!)

Anyway, thanks for the thanks. I'm glad to have helped.

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