[Question #11032] HIV From Receiving Oral Sex

17 months ago

14 days ago I received oral sex from a masseuse. It was for 5 mins & she used oil & a hand job to make me cum. I wiped myself with an alcohol wipe after. I masturbated a lot during that day. 3 days after, the tip of penis was burning, underneath my foreskin was red, pain in my right testicle and I was peeing a lot with urgency. I took an std test 6 days after initial contact and was negative. Over time all my symptoms have gone away. However on day 10 my lymph nodes in my neck felt discomfort. Now on day 14 I am feeling lymph node discomfort underneath my arm pits. I also have mild diarrhoea. I dont have an appetite but I am eating, I have lost a few kg over the 2 weeks due to stress & anxiety of having HIV. I felt very hot in bed last night and have few muscle aches.

I will test on day14 with std test(no HIV). My doctor said if nothing shows I don’t need to worry about std or hiv. If I test negative do you think it is safe to have sex with partner? Should I stop worrying about hiv?

H. Hunter Handsfield, MD

17 months ago

Welcome to the forum. Thank you for your confidence in our services.

Oral sex is generally low risk for all STDs -- low risk for all, virtually zero risk for many, including HIV. (There's never been a proved case of HIV transmitted mouth to penis.) The most common are gonorrhea, herpes due to HSV1, and nongoncoccal urethritis (NGU), often believed to result from exposure to entirely normal oral bacteria. Syphilis is possible, but it's so rare in partners like your that it's a minimal worry. Let's first address you penile symptoms and then your lymph nodes and diarrhea.

Gonorrhea could have explained the earliest symptoms, but is ruled out by the negative test results at 6 days. Herpes is unlikely with those symptoms now gone, without developing blister-like sores and ulcers. Your penile symptoms started much too soon to be due to syphilis (typically 1-2 weeks after exposure). Same for most NGU -- onset normally 1-2 weeks. However, there's an exception to that rule: sometimes NGU result from adenovirus, one of the common cold viruses. Do you know if your masseuse partner had respiratory symptoms (cold, sore throat, etc) at the time? But urethral adenovirus is a minor problem that rapidly clears on its own. At this point, with your penile symptoms gone, I agree with your doctor that it's no longer a concern for any STD; you can expect another round of negative results if retesting includes gonorrhea and chlamydia.

As for your diarrhea, muscle aching and "lymph node discomfort", most likely they are entirely unrelated to this sexual exposure -- just a coincidence in timing. The armpit discomfort doesn't necessarily mean lymph node problem: probably not, if enlarged and tender lymph nodes are not found by your doctor's exam. I'm not sure I understand your statement about 14 day testing, i.e. "std test (no HIV)". The chance you have HIV is exceedingly low, both because the exposure was little or no risk, as just noted above, and because your symptoms are not typical for acute retroviral syndrome (ARS, i.e. initial HIV infection). On the other hand, HIV testing usually is wise in this situation. Fourteen days is too soon to conclusively know HIV is absent. However, a negative result WOULD be conclusive evidence that your symptoms are not due to HIV. (It isn't possible to have HIV symptoms without positive test results).

At this juncture, it probably is safe to have sex with your regular partner. However, you might discuss all this with your doctor and maybe hold off until you have the next test results.

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

HHH, MD

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17 months ago

That is very reassuring that there has not been a proven case. I live in a country where HIV is not allowed, I could only do urine STD tests. I did a standard urine test as well as the std test on day 6 and my doctor said everything was fine. My day14 test results are all negative.

I cannot test for HIV for a few months but will test when travel. Do you think that would suffice? My muscle aches were mainly in my calf. I cannot feel any swollen lymph nodes in my armpits just a small bit of discomfort, but I can still feel some on my neck. So in your opinion would it be ok to live my life as normal and then check for HIV in a few months when I travel just to make sure?

H. Hunter Handsfield, MD

17 months ago

If you are an expat (e.g. worker) in a Middle East country with HIV restrictions -- like UAE -- it is nonsense that you cannot be tested for HIV. Lots of HIV testing goes on at clinics in Dubai, for example. If negative, there is no problem, or so I have been told -- that is, just being tested has no consequences. If you should test positive, you could be forced to leave -- but anyone with newly diagnosed HIV needs immediate health care, including anti-HIV drugs. So your health would require your departure within a few weeks anyway. This forum has interacted with many users tested for HIV in Dubai.

Self examination for lymph nodes will not help at all. Absence of lumps will not lower the chance you have HIV, and presence of enlarged nodes (without other typical symptoms of ARS) usually doesn't mean HIV. In general, symptoms are very poor in predicting presence or absence of HIV. Only testing can do that. Given your sexual history, the chance you have HIV is very low. But it isn't zero. You'll have to decide about testing. If you don't test, you'll probably continue to worry, and so I would recommend it. You can expect a negative result.

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17 months ago

Hi Dr.,

Yes I know I can get tested, but if I am positive, my life will be ruined. I have read your previous comments saying insertive oral sex carries 1 in 20,000 risk or like being struck by a meteorite.
I went to my doctor and the discomfort under my armpits was not swollen lymph nodes. I have some phlegm and nasal build up this week, but no sore throat or fever. I think I am ok. My doctor told me I should not worry and to live as normal.

17 months ago

I have noticed that some mosquito bites have made my skin flare up like skeeter syndrome. I have never been allergic to mosquito bites before.

H. Hunter Handsfield, MD

17 months ago

With proper health care, if you have HIV your life is unlikely to be "ruined" and I don't see this as a valid reason not to be tested when a) the risk of infection is near zero and b) the negative result probably would be very reassuring. But it's entirely up to you. There is nothing in the symptoms you describe that suggests you have HIV.

That completes the two follow-up comments and replies included with each original question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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