[Question #12299] Unprotected Oral M2M risk

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8 months ago
Hello Doctor. 

I am male 30yrs married. I regret saying this, however, i had an exposure on 28/10, i went to an asian massage parlor in Dubai and ended up only me giving unprotected oral sex to the male massage parlor while i got only a handjob. It was for almost 2 minutes only with little precum and i cleaned my mouth later with water. I have asked him if he was clean and free of any STI and he said yes. 

After 10 days i had like a sore in the roof of my mouth, which i visit a dentist and told me it was likely a mouth burn. I freaked out and tested for STD Panel at 14 days (11/11) and got all negative results. 

On 20/11, i had a severe flu like symptoms which i believe might be Flu A as my entire family were sick. I was given an antibiotic Cefixime 400mg once daily to treat my bad sore throat. However, i tested again on 25/11 which marks exactly (4 weeks) 28 days post exposure for 4th gen HIV and RPR +TPHA Syphilis and both are negative. 

As of now, i have a very bad burning sensation on my tounge and some white layer on lips (probably from biting my lips too much). I don’t know exactly if this is thrush or no. I remember it started immediately after i brushed my toungue but I can’t understand how could this be the reason. 

The questions are : 
1- Am i at risk of HIV as i have read online a case about a burning toungue was the only indicator for an acute HIV? 
2- Will the Cefixime interrupt Syphilis test and could it cure it if indeed i have it? 
3- Do i need to retest at 6 weeks again full panel? 
4- Is there a case where 4 weeks test of hiv turned positive at 6 weeks? 
Thank you 
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Edward W. Hook M.D.
8 months ago
Welcome to the Forum.  Thanks for your questions.  The exposure you describe was close to, if not, no risk.  Rates of HIV, as well as other STIs and STIs, including HIV are poorly transmitted through oral sex.  There is no risk of any STI from receipt of masturbation, even when partners get each others' genital secretions on each other.  In answer to your specific questions:  

1- Am i at risk of HIV as i have read online a case about a burning toungue was the only indicator for an acute HIV? 
The risk for HIV are almost zero.  It is unlikely your partner had HIV and, on average, performing HIV on a person with untreated HIV leads to infection only once in 10,000 acts of oral sex.  Burning tongue is not an indicator of recently acquired HIV.

2- Will the Cefixime interrupt Syphilis test and could it cure it if indeed i have it? 
If you acquired syphilis, that dose of cefixime would not cure syphilis.  Your risk of syphilis however is close to zero, particulalry in view of your negative blood tests on 25 November.

3- Do i need to retest at 6 weeks again full panel? 
At 4 weeks, tests will be positive in over 98% of persons who recently acquired HIV.  We have never seen nor heard of a person with a negative test for HIV at 4 weeks go on to develop a positive test.

4- Is there a case where 4 weeks test of hiv turned positive at 6 weeks? 
See above

I hope that this information is helpful.  Please don't worry.  EWH
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8 months ago
Hello Doctor, 

Thank you for your reply. I really appreciate it and it made me feel much better. To ease my worrying mind, i did another test on day 40 for both RPR & HIV 4th gen and both were negative since i have been ill for 3 weeks now. 

The only thing i am suffering with now is the mouth ulcers. I have got more than 3 ulcer on my hard palate. I went to 3 different dentists and each one of them gave me a diagnosis. First doctor said it might be a pizza burn, second doctor said it herpes and the last doctor said it was a normal ulcer which is harmless. I am not sure what tests more i need to do to identify those ulcers. They certainly feel like a burn, however, this is the first time i get them on my hard palate. 

From your point of view, could this be related to the exposure? If yes, what should i do? 
Can i be confident to rule out Syphilis and HIV? 
Could the mouth ulcers be herpes? I remember having herpes on my lips only when i get a flu or common cold but never in my mouth roof. 

Thank you Doctor. 

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Edward W. Hook M.D.
8 months ago
Thanks for the additional information.  Your test results prove that you do not have HIV or syphilis and that your symptoms are not due to these infections.

Your mouth ulcers are not suggestive of any STI.  Typically herpes lesions occur on the lips and outside of the mouth, only occasionally occurring inside on the palate  at the time of initial infections.  Since you have had cold sores in the past, you can be confident your oral lesions are not herpes.  There are no STIs that would cause these lesions (syphilis might cause lesions but if your lesions were due to syphilis, the tests would certainly be positive

It is time to set your concerns about STIs aside.  I would suggest that you see an ear, nose and throat specialist about your oral lesions.  EWH
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8 months ago
Thank you for re-assuring me doctor. 

I am still worried on Syphilis and i don’t want to transmit it to my wife. Although, i have been sexually active with her for the past couple of days. I just have this feeling stuck with me as it might be syphilis. 

As i have mentioned earlier doctor, i took 5 days course of Cefixime 400MG and after two days from completing the course, i got another ulcer on my mouth roof. 

Could it by any chance interfere with my RPR test? I did the test exactly after 7 days from completing the course. 

Is there a need to test again just to confirm? 

Sorry doctor i am just too nervous about this and I can’t really talk to anyone. 
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Edward W. Hook M.D.
8 months ago
This is a repetitive question.  I said above, "Your test results prove that you do not have HIV or syphilis and that your symptoms are not due to these infections."  The answer is not going to change.  I've already also told you that the cefixime you took would not cure syphilis BUT, if you had syphilis, your test would be positive.  

I see no medical or scientific need for additional testing

This completes this thread.  you should not return to the Forum regarding this encounter, the answer will not change, you may not get a response, and your posting feel will not be returned.  EWH



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