[Question #11247] Hiv or std risk

15 months ago

Hi Dr,

Wanted to consult you regarding a recent exposure.

Since last 2 days i have a fever upto 100 degrees Farhrntide and 38 degrees celsius . No body pain or weakness . Slight cold and mild cough .

Few weeks earlier i kissed someone i know . It was a deep kiss . I noticed that this person had chapped lips .After i kissed him i noticed his lips a bit red in colour coz they were chapped .

Is it a risk for hiv ? Very worried . request you to please advise . Could this be ars ?

H. Hunter Handsfield, MD

15 months ago

Welcome back -- but I'm not sure I understand why you felt the need. Your questions are nearly identical to the ones discussed with Dr. Hook two months ago. As he said then, fever alone is not a symptom of ARS and never suggests infection with HIV or any other STD. Also, ARS doesn't cause cold symptoms or cough. He also advised that HIV and STDs are not transmitted by kissing; chapped lips etc make no difference. You were not at risk and your symptoms have nothing to do with your recent kissing event.

In your sexual activities with other men, you'll never be at risk for HIV until and unless you have anal sex. And symptoms like these are never likely to be due to HIV or STD. Let's make this your last question along these lines. Thanks.

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

HHH, MD

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15 months ago

Thanks a lot dr .

1. Is kissing no risk , even in case of blood ? I noticed the chapped lips were slightly darker later although i didn’t taste blood

2. Is deep kissing tongue to tongue also considered no risk ?

3. Should i consider prep in case my exposures are only going to be oral sex and kissing in the future ?

4. The fever seems to be stubborn and not going with dolo . It’s as high as 100.4 degrees . Would it be symtoms if any other std ? I have never had anal sex .

5. I read many websites saying kissing is low risk . That’s the reason i got more anxious . The CdC too says low risk . Request you to plz advise . Thanks

H. Hunter Handsfield, MD

15 months ago

You're asking the same questions in different words.

1. No risk even with blood.

2. No risk.

3. You should not take PrEP now or after future oral sex or kissing exposures.

4. There are many causes of fever and I have no way at guessing the cause in your case. But fever alone never is due to ARS or STDs; if those were the cause, you would have other symptoms.

5. I don't understand. I agree kissing is extremely low risk. Nobody can guarantee it is zero risk, but in the 40+ years of the worldwide HIV/AIDS epidemic and millions of HIV infections, none have been known to result from kissing. As discussed in your previous thread, there is no difference between "low risk" and "zero risk" in common, day to day advice about HIV transmission.

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15 months ago

hi dr,

Thanks for your detailed explanation .

Had a few follow up questions .

1. Most people who kiss also end up having anal sex , so how do we know that kissing is no risk . How can we attribute whether those persons were infected by kissing or anal sex ?

2. Is tongue to tongue kissing also no risk ? What if the other person had a cut and i did it notice .

3. Today is the 4th day . I still have fever upto 100.5 F and a cold on and off.

Request you to please advise on the above . Thanks

H. Hunter Handsfield, MD

15 months ago

1. Excellent question and worthy of a thoughtful reply. Of course it isn't possible to know the specific practice that resulted in virus transmission when there were several of them. By the same token, how can we know that cunniligus didn't transmit HIV when it followed or preceded vaginal intercourse? Actually the answer is pretty simple: the busiest STI and HIV/AIDS clinics and practitioners report rarely or never seeing infected patients whose only exposures were kissing, cunnilingus, or as the insertive (penile) partners in fellatio. And careful analysis of these issues (mostly done early in the HIV/AIDS epidemic, i.e. 20-30 yr go) found that most persons who reported such exposures as their only risk turned out to be wrong when more detailed info became available: some were lying (saving face over exposures that embarrassed them); some were unaware that a regular partner had HIV, mistakenly attributing their infection to an open mouth kiss in a strip club or something similar; or simply didn't remember a sexual event when drunk or high; and so on. However you cut it, there are simply no (or exceedingly few) proved sexual transmissions of HIV that did not include vaginal or anal sex.

2. It's easy to imagine that more prolonged, vigorous kissing, with lots of tongue contact, is more risky than less intensive kissing. But the above factors still apply. (There's actually some data that kissing may be more risky for gonorrhea than previous believed. It's controversial, but to the extent true, it appears to be limited entirely to MSM and perhaps related to especially prolonged or vigorous oral-oral contact.)

3. There are hundreds of causes of otherwise unexplained fever, and newly acquired HIV is probably among the rarest. This still is something you should not ignore: there's a medical term for what you have, fever of unknown origin (FUO). When it goes on more than a couple of weeks, some cases are quite serious: tuberculosis, various fungal infections, endocarditis (heart valve infection), hidden deep abscess somewhere, and various cancers. Take it seriously and see a doctor -- perhaps an infectious diseases specialist. But in view of your exposures, you can be very sure it isn't HIV.

That concludes this thread. I hope this and the previous discussion are helpful to you. Best wishes and stay safe.

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