[Question #10385] Tonsilitis - increased risk for HIV from oral sex?

23 months ago

I had tonsillitis c.2 weeks ago. My throat was in agony but I had no other symptoms (no fever, etc.). Doctor thought it was viral. It subsided and I felt much better after 1 week.

I then had oral sex with 3 males (I am male, I was giving the oral sex) on Tuesday 5 Sep & Friday 8 Sep. On Sunday 10 Sep I got a high fever & my sore throat has come back on one side only, I also have headache, muscle aches & the glands in my neck (one side, same as my sore throat) are swollen/painful. Feels like flu but these are classic ARS symptoms. GP prescribed antibiotics in case bacterial.

Could this be ARS - given my tonsils may not have fully recovered, was I more likely to have acquired if my throat was raw/infected? Would a test taken now be positive if these symptoms were due to ARS?

Edward W. Hook M.D.

23 months ago

Welcome to the Forum. Thanks for your questions. I’ll be glad to comment. Statistically performing oral sex is a very low risk sex act; the CDC conservatively estimates that the risk for acquisition of HIV, if your partner had untreated HIV is less than 1 infection per 10,000 encounters. Thus it is statistically unlikely that your recent sore throat was due to HIV. As you point out however, while your symptoms began too soon to be typical of the ARS, characteristics of the ARS do include sore throat, fever, and flu-like symptoms similar to those you experienced. As you also point out, if your symptoms were due to HIV, a HIV test would be positive. While I anticipate that the results will be negative an HIV test at this time will show that your symptoms were dou to some other viral illness such as COVID, influenza, or one of the far more common causes of symptoms such as yours. Given your multiple recent partners, while Gonorrhea is unlikely ( oral Gonorrhea is usually asymptomatic), I would suggest a throat swab for Gonorrhea as well (typically the swab will also be tested for chlamydia- it’s built into the test).

My guess is that your recent symptoms were coincidental to the exposures you describe but testing is certainly reasonable. EWH

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23 months ago

Thank you. I'm confused, I never said my symptoms began too soon: is that your assessment? Also can you please answer my question about whether tonsillitis/sore throat can increase chance of acquiring HIV from oral sex? 1 in 10,000 is presumably based on a healthy mouth.

Edward W. Hook M.D.

23 months ago

Sorry for the confusion. The ARS most typically begins about 10-14 days after acquisition of infection. Thus it is MY assessment that your flu-like symptoms occurred too soon after exposure to be the ARS.

Having tonsillitis or a sore throat at the time of exposure is not known to increase risk for HIV.. the 1 in10,000 conservative estimate is just and estimate and is likely conservative however there are too few cases of HIV acquired in this way to provide a more accurate measurement. EWH

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23 months ago

I just did a rapid at home antibody test (Insti) and it was negative. How reassuring is this - if the current flu like symptoms I have been experiencing for the last few days were due to ARS would this test have been positive?

I am also sending off an antigen/antibody duo lab test today, along with a full suite of STD testing for other infections. Is there any chance these results could be inaccurate/affected by my current illness and/or the fact I am currently taking penicillin?

Thank you again.

Edward W. Hook M.D.

23 months ago

If your symptoms were due to the ARS, you would have antibodies to HIV. The ARS is due to the interaction of circulating virus and newly formed antibodies. Similarly, I anticipate that your combination HIV antigen/antibody test will also be negative as well, proving that your symptoms are not due to HIV.

Penicillin will have no effect on the accuracy of your test. Test for other STI’s will also be reliable.

I suspect you are aware, we provide up to three responses to each clients questions. This is my third response and therefore this thread will be close shortly without further responses. Please don’t worry. EWH.

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