[Question #1045] Unprotected Receipt of Oral Sex by TS

97 months ago

On June 29th, I received unprotected oral sex from an hispanic transsexual escort in Atlanta, GA. The oral sex didn't last long (maybe 1 or 2 minutes). The escort inserted a finger into my rectum and was touching their penis before this. I got nervous about this encounter afterwards, a few days later I texted and asked their HIV status. They said Negative and asked why I wanted to know. 12 days after the exposure I had an HIV-RNA test done by Labcorp and it came back negative. I decided to have one more test to settle my anxiety completely so I had a 4th Generation HIV test done by Quest 27 days 2 hours after exposure. It came back negative.My mind was at ease until 34 days after exposure (08/02), sinus and nasal discharge started running down the back of my throat heavily. My throat got kind of scratchy, maybe a little sore over the next day or so. I started sneezing some, blowing clear discharge out of my nose, one of my nasal passages felt stopped up. Over a day or two it turned some clear some yellow. Past couple of days I've been coughing some and coughing up some yellow mucus from my lungs. My voice has sounded funny due to the congestion I believe, since my throat hasn't been really sore or anything. I've taken my temperature a lot, it was normal every time, other than twice. It was 99.1 and 99.2 after I came home from working on a house I've been working on. It went down to normal pretty much within an hour or so. It seems like after the nasal discharge started, I would sweat a lot when doing minor work. I thought a lymph node behind my right ear might have been swollen, it felt tiny like the size of a rice gran, and it was sore. I can't really feel it now and it's not sore anymore at this time. Right now, my voice still sounds a little funny like I'm congested but my nasal passages seems to be pretty clear. The drainage has significantly slowed. The nasal discharge that I'm blowing out now which is not very much seems to be yellow with a green tint. The other symptoms I seem to have a reddish spot on my face near my right ear which seems to have a small couple of bumps or bumpy. Several days before the discharge I had painful knees and put biofreeze on them and they quit hurting.

What scares me is I rarely get sick, and I didn’t think colds were likely in the summer time. Do you think I need further testing? I take two AHCC tablets daily, a zinc, and a multi vitamin daily. Could this have done anything to my HIV tests?

H. Hunter Handsfield, MD

97 months ago

Welcome to the forum. Thanks for your question.

You needn't worry at all about having HIV from this event. First, oral sex is safe sex in regard to HIV, with little or no transmission risk. There has never been a proved case of HIV transmission mouth to penis. Fingering also is risk free. Second, it seems very unlikely your partner had HIV; people rarely lie when asked directly (even sex workers), and it statistically unlikely she has been infected since her last test. Third, your negative test results prove you were not infected: it is not possible to have HIV and have negative RNA and 4th generation testing at the times you were tested. (And your vitamins etc have absolutely no effect on your HVI test results. No medications hdo that.) Fourth, your symptoms are not typical for a new HIV infection -- but even if they were, test results always overrule symptoms. For sure something else is causing yoru symptoms. Sound like you caught a cold, that's all. Colds indeed are more common in the winter, but only slightly less common in the summer.

So all is well. You don't have HIV and do not need further testing. If you have a regular sex partner, you can safely continue sex without risk of transmitting HIV.

I hope this has helped. Best wishes and stay safe-- HHH, MD

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97 months ago

Hi Doctor - I appreciate your quick response. It eased my nerves due the symptoms I was experiencing which I found unlikely since I rarely get sick, especially not in the summer time.

I wanted to further re-assure myself, so I tested again using a 4th generation test somewhere around 41 days 22 hours after exposure. It came back negative, so I think I can rest my mind permanently about this matter.

I've done a lot of reading about HIV and testing windows, and I have a question just out of curiosity. I'm not sure what's considered an infectious HIV level, I think I read >50,000 copies of virus per ML of blood or something. If someone was exposed to say 60,000 copies of virus vs someone exposed to 600,000 copies of virus, and they were both infected, would identical HIV tests turn positive around the same day, or would the person that was exposed to 60,000 copies of virus take more days?

My mind is at ease regarding HIV and I didn't experience any genital lesions so I'm assuming I didn't catch HSV-1 transmitted from oral to genital. I still want to get a full STD panel to ensure I haven't got anything from this exposure or previous encounters. How long do you recommend I wait to have this testing conducted?

Again, appreciate your response and offering your knowledge on here. Have a good day.

H. Hunter Handsfield, MD

97 months ago

The speed of developing positive tests for HIV is unrelated to the "dose" of virus at the time of infection. (If there is any difference between a high-viral-load exposure and one with low viral load, it would be measured in a day or two, not several days or weeks.)

I recommend against the "full STD panel". Given this sort of exposure, the chance of misleading results (false positive, or positive results unrelated to this exposure) is far higher than the possibility of detecting an infection from that event. It isn't worth the risk (or the cost), in my opinion.

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