[Question #10458] Saliva wound and oral
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22 months ago
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Hi Dr,
In a drunk state I visited a massage parlour in London. The masseuse was Chinese and I think she used to live in China then moved over to the UK.
I assumed she would give me a body massage with a handjob. However she ended up offering me oral sex and vaginal sex. (So I can only now assume she was as much a prostitute as she was a masseuse.
I accepted the oral sex (Unprotected) but luckily refused the vaginal sex. She performed oral sex/fellatio on me for about 10 minutes.
I also had a cut on my fingertip which happened 2 and a half days earlier. It was bleeding quite a bit when the cut 1st happened and stopped after about 10-20 minutes and it left a small red circular wound about 1cm wide.
I did not finger the her but, (without realising), i did rub her saliva that was left on my penis quite a lot directly into my finger wound when I masturbated straight after she performed oral sex on me.
8 days after this incident I got a sore throat which lasted for 1 week and an intermittent dry cough (non productive). The cough lasted for about 2-3 days and was very mild and sporadic. I didn't notice any fever throughout this time and even took my temperature a few times which was always around 36.5 c. However I did have night sweats on 1 single evening (this happened about 5 days after sore throat started and 14 days after the initial incident).
Do you believe i'm at risk of HIV from this incident?
Do my symptoms and their timings sound like HIV?
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Edward W. Hook M.D.
22 months ago
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Welcome to our Forum. Thanks for your questions. I'll be glad to comment. I have no concerns that you might have acquired HIV from the encounter that you describe. Even most commercial sex workers do not have HIV and HIV is not transmitted through exposure to saliva. There are no cases of HIV which have been proven to have been acquired due to receipt of oral sex, due to saliva exposure, or due to masturbating ("fingering") an infected person, even with an open cut on the finger. I would not be worried at all that these symptoms were due to HIV. In fact, no only do I see no reason for concern but I see no need for testing either.
I hope this perspective is helpful. EWH
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22 months ago
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Hi Dr Hook,
Thanks for your reply, I do find that reassuring.
I have some more questions which I would appreciate if you could answer:
1.) Did my symptoms and their timings sound the same as acute HIV? (i.e started 8 days after exposure, sore throat for 1 week, a very mild sporadic dry cough for couple of days and no noticeable fever (my temperature was always around 36.5c) and no rash either (although there was 1 single episode of night sweats 14 days after the exposure). Other than these symptoms I felt quite well and continued going out, going to work etc
2.) The prostitute actually offered to have unprotected vaginal sex with me (which i refused), but the fact that she was so easily willing to have unprotected sex with a stranger suggests that she was at higher risk than the average sex worker. Does this change your assesment of my risk from the incident at all?
3.) I am uncircumcised, does this effect your assesment of my risk at all?
Thanks
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Edward W. Hook M.D.
22 months ago
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Straight to your questions
1. A sore throat can certainly be part of the symptoms of recently acquired HIV however the sore throat is typically accompanied by severe flu-lu-like symptoms including high fever and severe muscle or joint aches. These symptoms however can be caused by lots of other "every day" viral illnesses such as influenza, COVID-19, and a long list of viruses. When persons with the classical flu-like illness described above have been studied, 99% have something other than HIV. Further, cough is NOT a typical part of the symptoms of recently acquired HIV. Bottom line- no, your symptoms do not suggest HIV.
2. The risk of sex workers having HIV is, as a generalization low- typically 1% or less. While it is reassuring when condom use is required, it is not unusual for CSWs to offer unprotected sex.
3. If you were exposed (remember, receipt of oral sex does not count as an exposure, however, IF exposed to an untreated, HIV infected partner, being uncircumcised would somewhat increase your risk of infection- for unprotected vaginal sex this would mean that the risk of infection would go, ov average, from 1 infection per 2500 exposures to 1 infection in 1250 (on other words over 99.9 of exposures to infected, untreated persons would still not lead to infection)
I hope this additional information is helpful. EWH
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22 months ago
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Thanks Dr Hook,
Again many thanks for your answers.
I have some final questions, apologies in advance for the specifity of them but its information that will be good for me to know
1.) As mentioned i had 1 night where i had night sweats and woke up in a drenched with sweat bed. Is this how an ars fever could behave and do night sweats always mean a fever? Again i didnt notice any fever for the rest of the time i had symptoms and took my temperature on 3-4 days over the course of a week and was always around 36.5c
2.) would having any concurrent STD's (for example warts, herpes etc) raise the risk of contracting HIV from recieving ORAL Sex? Im not saying I have them but i know some of these STD's can be mild or symptomless so i will be interested to know.
3). You mentioned cough isn't a symptom of initial HIV, does this include both Dry cough (which is what i had which comes more from the throat) and productive/mucus cough which comes more from the chest?
4.) i have a girlfriend (and have felt terrible about this mistake and for sure wont be making it again). Would you say its ok to resume unprotected sex with her in spite of this incident?
5.) The cut on my finger was 2 and half days old but was bleeding quite heavily initially. Does the 2.5 days healing time make it safer and help form an effective barrier against HIV on the wound?
Many thanks
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Edward W. Hook M.D.
22 months ago
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Final Responses:
1. Night sweats are a non-specific symptom. The have many causes include reflex. They are not suggestive of any STI nor for HIV.
2. There are no data to suggest that HPV or a history of herpes would increase the small-modest risk for acquisition of other STIs.
3. No cough of any sort is suggestive of recently acquired HIV.
4. I see no reason related to the situation you describe to abstain from unprotected sex with your regular partner.
5. Cuts of the sort you describe, recent or otherwise do not represent a risk for acquisition of HIV. The idea that they do is a commonly held misperception.
As you know, we provide up to three responses to each client's questions. This response will complete this thread. I hope that the information I have provided is helpful EWH
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