So I plan to get tested at 28 days. Two days away. As a recap, I had made a thread because I had a prolonged (2 hr) insertive oral even that resulted in gonnorhea and I am terrified I may get HIV from it. I am sorry for returning. I am scared to get my partner sick, especially as we discuss family planning. 

Let me ask you: 

1) is tonsillitis typical of ARS? The soft palate of my mouth has a reddish ring around it as of the 10th of June (I had an instant test that day- day 17, chembio, and it was negative) and today I see some white dots on my tonsils (first time I’ve seen these). My tonsils don’t look particularly enlarged.  I have had no fever, minor muscle pains if any, and no noticeable lymph nodes (maybe some armpit soreness/ tenderness). I’m worried that the white dots could be due to ARS related tonsillitis. Is this something you’ve seen? Or a red ring around the soft palate (deeper red near the “arch” of the small palate when the back of the throat is examined). I don’t think my throat has been particularly sore but maybe slightly irritated the last week or so. 

2) I wear a fitness band and my heart rate and HRV have been normal. Would I have a rapid heart beat if infected?

3) are painful armpits a symptom of inflamed nodes? 

4) I noticed that you both are a bit more cautious in how you discuss insertive oral. Have there been any case reports which indicate this may occur? I found a PLOS study which claims that insertive oral has resulted in transmissions.

Thank you. I will be tested soon. 

Thanks -- HHH, MD

Thank you

1-3) All three of these questions are irrelevant at this point. It is never possible to have any symptom due to HIV in the presence of a negative test result. The time since exposure to the test doesn't matter:  if the next is negative, HIV is not a possible cause of symptoms at that time. That's because it isn't HIV itself that causes ARS symptoms, but the immune response to the virus -- which is indicated by antibody. Therefore, antibody always is present with HIV symptoms. Thus it doesn't matter in the least whether or not tonsillitis (question 1), abnormal heart rate (no. 2), or painful armpits (no. 3) can occur during ARS. Given your test results, HIV is not a possible cause of any of these. (However, none of these is a likely ARS symptom, with the possible exception of tonsillitis.)

For those reasons, we always advise people concerned about a new HIV infection to entirely ignore symptoms no matter how typical they may seem to be. Even with more typical symptoms than these, usually there is another cause; and anyway, half of all newly infected persons have no symptoms at all. Thus:  Rely on blood tests to determine possible infection. Nothing else.

4) I'm unaware of the PLOS report you mention. Our understanding is that there has never been a scientifically proved case of HIV transmitted oral to penis. But what if there are a few that actually happened? Out of the billions and billions of oral sex events that must have occurred between HIV infected and uninfected partners? Based on how people thought they had been infected -- which often is mistaken -- CDC once calculated a risk of one chance in 20,000 for oral to penile transmission, if the oral partner had HIV. That's equivalent to receiving BJs by infected partners daily for 55 years before transmission of the virus might be likely. In other words, zero for all practical purposes.

Does that help?

HHH, MD

A drug like amoxicillin wouldn’t stop hiv related tonsillitis right?

One last question for now (I’ll save the final, if I have it, to let you know the outcome) do you think I could be infected? I’m pretty anxious now and trying hard to rationalize everything. I know you’re not a therapist but do you think prolonged exposure could have transmitted to me?

"do you think I could be infected?" What exactly isn't clear about my comments above???

Also, you've already heard that you had a nearly zero risk exposure for HIV, regardless of the duration of the event. And one more fact might interest you:  In the 20 years of this and our preceding forum, with thousands of questions from people concerned about having HIV, not one has yet turned out to be infected. You won't be the first. If and when it happens, undoubtedly it will follow a genuinely high risk exposure.

I suggest you crack a beer or light up a joint, go to a mirror, look yourself in the eye, toast yourself with "Congratulations, you don't have HIV", have a good night's sleep, and stop worrying!

My throat has been bothering me for 10 or so days (the red irritation was present when I did the instant test) but I didn’t really see anything on my tonsils until today, which is why I freaked out. I also am concerned about spreading anything to my partner because of my lapse in judgement (which truly was limited to this oral exchange).

Anyway, thanks again. I hope you’re right. I won’t be back unless I have something to report out of the ordinary. Cheers. 

Trust the CSW. People rarely lie or falsify such information.

That completes the two follow-up exchanges included with each question and so ends this thread. You really shouldn't need to return, but I'll make a deal with you:  if despite all science, logic and common sense it turns out you are diagnosed with HIV or any other STD, feel free to return and let us know -- and we'll refund your posting fee. (DO NOT read this as meaning I believe there is any chance you have HIV. I do not.)

I'm glad to have helped. Thanks for the kind words about our services. Best wishes and stay safe.