[Question #10683] Risk assessment and HIV symptoms

20 months ago

19 days ago I had sexual intercourse with a prostitute whose HIV status unknown . she is also one of those who wander in the streets and bars and never use protection. In other words , the cheap ones . I used a condom ,which did not slip or broke.but it's covered only half of penis . In the end she removed it and performed oral sex on me(blow job) . She threw up on my penis and was unable to continue so she switched to handjob till I ejaculated . And I think her finger was bleeding , cause she broke her finger a while ago when she entered my home. I did not insert my penis in her vegina after the condom was removed . But I fingered here with my hand , nd my finger nails were clipped just in the morning of that day , dn there were some non bleeding cuts there due to the clipping .
After 14 days I started to experience very severe symptoms , loss of appetite , pain in my lymph nodes in the neck ,armpit and groin. .Nodes in my armpit were visible . Moderate fever that goes off after taking paracetamol. painful sore in my mouth, sore throat and find hard to swallow something. Muscles pain . These symptoms lasted for 3 days , the severity subsided .And the 4 th day I felt a little better and I still not well . Now it has been 19 days since the incident.
My question is am I at risk ?

Are those HIV symptoms ?

Edward W. Hook M.D.

20 months ago

Welcome to our Forum. Thanks for your questions. I'll be glad to comment.

The exposure you describe was low risk. Most commercial sex workers do not have HIV. Further, there are no proven cases which have been acquired from receipt of oral sex and condom protected vaginal sex is safe sex as long as the condom covered the tip of your penis and was worn throughout sex. In addition, receipt of masturbation is also considered safe, no risk sex, even if your partner had a bleeding cut on her hand. As you might image, there are no studies of the effect of a partner vomiting on the penis but I would presume it is safe sex.

The timing of the onset of your symptoms correlates with the time when persons who have acquired HIV experience symptoms (i.e. between 10 and 21 days following an encounter) and some of your symptoms are not of recently acquired HIV. The symptoms of recent recently acquired HIV are high fever, severe sore throat and widespread muscle or joint aches. Painful lymph node swelling is not typical. Even when at risk persons develop the symptoms I describe however, less than 1% of those persons are found to have HIV. The rest have the flu, COVID 19, or one of the many non-STI viral illnesses that most persons get from time to time. You can determine if your symptoms are due to HIV by testing- the symptoms of recently acquired HIV are caused by the presence of antibodies to HIV and HIV p24 antigen and for this reason, standard, 4th generation tests for HIV are always positive when symptoms are due to HIV. If you choose to test at this time and the test is negative, as I anticipate it will be, you can be confident that your symptoms are not due to HIV. Of course HIV can also be acquired without experiencing symptoms so, depending on your level of concern, you may want to test at some point more than 6 weeks after your encounter. Test results obtained more than 6 weeks after an encounter are entirely conclusive.

I hope this information is helpful. Please don't worry- as I said above, this was a very low risk encounter. EWH

---

20 months ago

Hello, doctor thank you for your answer it's was a little assuring.

But this symptoms made me really worried. If it wasn't for symptoms, I will never ask anyway . Cause before the incident , I was confident that oral sex is zero risk for HIV .

Any the symptoms I have now is dry mouth , sometimes parts of body fell Hot and warm . Like my back for example . Pluses the fever did not go , but the fever it's not the extent my body will sweat or I can't get up . It's like my body temperature is little high that's all.

And I have an other question . At three days I had weird symptom . Like my anus was painful and itchy . And I start to fell a little tired and my body temperature rised a little . This symptoms last for 3days .and then after 14 days I start to fell the symptoms I told u about in the first question

Edward W. Hook M.D.

20 months ago

You are correct that there is no known risk for HIV from receipt of oral sex. If you are worried, the best way to address your symptoms is to get a test. When it is negative, you can be confident that your symptoms are not due to HIV but due to some other, non-STI cause.

The anal itch you experienced is almost certainly unrelated to the exposure you have described.

I hope you are beginning to feel better. EWH

---

20 months ago

Thank you doctor , I have one last question , then you can close this question .

Is globus throat a sign of newly acquired HIV: because o found I don't sore throat , o fell like I have a lump in my throat .

And thank you for help much appreciated.

20 months ago

An other update of my symptoms :

Rash on my hand : little red spots like 1 cm wide .

Severe pain in my back right thigh .

My question is does ARS symptoms come all together , or they come in a wive . Cause the previous symptoms has subsided .

And is muscle pain related to HIV usually localized or general .

Edward W. Hook M.D.

20 months ago

Thanks for the update on your symptoms. Localize rash or muscle pain is not suggestive of the ARS. The muscle aches associated with the ARS are generalized, not localized. When persons experience the ARS, the symptoms tend to all occur at about the same time. Your symptoms do not suggest the ARS to me.

As you know, we provide up to 3 responses to each clients questions. This will be my final responses. Please don't worry. EWH

---