[Question #12322] Unprotected oral and HIV fears

8 months ago

Dear Doctor,

I am married straight curious (37M) guy and recently met another straight curious guy (41M), unmarried from A4A. He tested negative for HIV in May 2024 and no sex after this neg result.

11/14 - Gave oral to him unprotected for about 20-30 min, no ejaculation at all. It was alternating between hand jerk and oral during that time. It was deep oral and him pushing it to back kind of made my upper palate little sore and red for few days.

11/26 ( Day 12) – Whole body severe itching rashes (hives/pimple like). Cleared in 2-4 hrs with Benadryl. No fever or chills or muscle pain or sore throat.

11/28 - 12/3 - On going dry throat, Some post nasal drainage, intermittent running nose/cough and some sputum (green).

12/2 (Day 18) – Forehead temp was around 99.7 F however ears and cheeks are very red and hot (red ear syndrome from anxiety ?). The cheek temp was about 102 F and constantly changing from 99 to 102 F every reading. No chills, sweating, whole body rashes or muscle pain or sore throat overnight.

12/3 (Day 19) – No fever as of morning, forehead temp 98.1 – 99.5F and fluctuating with every reading based on forehead location.

Is this suggestive of recent HIV infection or typical of any symptoms associated with ARS ? Do I need to get tested for HIV ?

Edward W. Hook M.D.

8 months ago

Welcome to our Forum. Thanks for your questions. As explained below, the encounters you describe are very, low, virtually no risk encounters. Based on your partner's history, he does not have HIV and thus you are not at risk.

FYI, performing oral sex on a person with untreated HIV is a low risk event with an estimated risk of acquiring HIV of less than 1 in 10,000 exposures. The are no proven cases of HIV which have been acquired from receipt of oral sex from an infected person.

Testing is a personal choice. I do not feel strongly that you need testing. Recently acquired HIV can cause the so-called ARS (acute retroviral syndrome) which is characterized by HIV fever (over 101) severe sore throat, and widespread muscle and/or joint aches (like the flu). The same symptoms can be caused by influenza, COVID-19 and a wide variety of community acquired viral infections. Your illness sounds rather mild to be the ARS and as I explained above, based on your partner's history, this was a no risk event. If you wish to prove that your symptoms were not due to HIV you can test now. When symptoms are due to HIV, tests are always positive (otherwise, in asymptomatic persons, test results are not conclusive until 6 weeks following a possible exposure. EWH

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8 months ago

Dear doctor,

Thanks for your prompt reply regarding my fears. Partner claims he tested negative in May 2024, however since I do not know him, I am not entirely sure if he is being genuine or just lying. He assured me several times after that event that he is 100 percent clean for all STD's including HIV. Worst case, if he lied and is HIV positive, is this still a low/no risk event that does not warrant further testing ?

1) Rash on day 12 is body wide and itchy rash, does ARS rash itches? can it present by itself as standalone symptom without other symptoms? Can it be short lived like 2-4 hrs.?

2) On Day 18, I only had fever for maybe 12 hrs (9 pm to 9 am) and it did not come back on day 19. Can this stand alone, short lived (12 hrs only) fever be a symptom as well without other presenting symptoms in HIV infection?

3) All of my symptoms (rash or fever) are standalone symptoms with no overlap among them on those days. Does this provide some reassurance that this is definitely not related to HIV? Do ARS symptoms always present in cohort at the same time (Fever + swollen lymph nodes + sore throat + rash +muscle ache/chills) and not as a standalone symptom(s) on multiple different days.

4) Can I be confident to put all this behind and move on with life with no fear of HIV/any other STD? Can I continue to have unprotected sex with my wife without any further fear of HIV/STD based on this low/no risk event (depending on his status)? or should I definitely get tested?

Edward W. Hook M.D.

8 months ago

I’m sorry you are having trouble with the reply I provided. As I told you, if your partner had HIV you risk of acquiring his infection is low. Please see above for the proportion of infections which would occur.

The symptoms of the ARS all occur at the same time. Your symptoms really do not suggest the ARS. That said, some of our clients find that they can best addressed their anxiety by getting tested. Testing is always a personal choice. Perhaps you should consider this. EWH

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8 months ago

Thank you doctor. My anxiety is really getting to me despite reading several answers on this forum from you and Dr. HHH. While I wanted to put this aside and move ahead, i started panicking again "what if that low probability could really effect my life". Its been 21 days since me performing unprotected oral on a guy (he claims to be HIV negative status but not known to me personally).

1) I noticed that I am getting some mild pain in arm pits especially when i touched(near breast tissue) along with mild pimple like rash) - on day 20 and day 21 - is this too late for any ARS symptoms at all ?

2) I also had mild running nose, all day sneezes on day 20, 21 and i also have night sweats on these two days (not so much drenching clothes or sheets but more like sweating in hot weather around neck and back)- I do not have any fever at all till now (always day temp is less than 99F) and how is it possible to have night sweats without fever. My anxiety is now skyrocketing thinking what if this could be due to HIV.

Please advise, have you ever come across anyone on the forum or in your entire career - to have been infected with HIV due to the just performing fellatio without ejaculation ? I am really scared to go for testing because these symptoms are coming out of no where in random (no fever yet above 101 F) and I am not sure what is causing them. I know you mentioned somewhere in forum that even though people have ARS symptoms, 99% of them will test negative for HIV and it is always due to something else. I am mind boggled by the coincidence of the the timings/my symptoms, I do hope that I pull courage to test and that my test comes out negative and helps me come out of this anxiety/panic mode. I thank you for your continued feedback on this forum.

8 months ago

Hi doctor, not sure if you had a chance to look into my follow up question above. Just wanted to make sure it was not lost in the list here. Thank you.

Edward W. Hook M.D.

8 months ago

Please be patient. We are not on the site 24/7. This is a repetitive question which will need to be your last.

As I told you at the time of your original question, "...performing oral sex on a person with untreated HIV is a low risk event with an estimated risk of acquiring HIV of less than 1 in 10,000 exposures. The are no proven cases of HIV which have been acquired from receipt of oral sex from an infected person." That answer is not going to change.

1. 21 days is not too late for the ARS but your symptoms are not those of the ARS. Your symptoms however, are not those of the ARS. As I told you in my original reply, "Recently acquired HIV can cause the so-called ARS (acute retroviral syndrome) which is characterized by HIV fever (over 101) severe sore throat, and widespread muscle and/or joint aches (like the flu). The same symptoms can be caused by influenza, COVID-19 and a wide variety of community acquired viral infections."

2. Night sweats are NOT a sign of the ARS.

I am confident that your test will be negative if you choose to test.

This thread is now complete. You should not return to the Forum with further questions and if you do you may not get a response and your testing fee will not be returned. EWH

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