[Question #13731] Hiv msm??
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1 months ago
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Hello docs I have had 3 encounters since my final test I am going to put my most recent one on the first question. The encounter involved a male/transgender and it involved deep making out( I have alot of dental work I need in my mouth . He performed oral sex on me for about 5 minutes, I also maybhave either hsv1 or balanitis on my penis. So possible open sores on my penis, and I performed protected anal, no breakage of the condom. I found a few odd things during the encounter such as a little bit of blood and stool on the condom after the sex
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1 months ago
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During the encounter he did something super weird . Kept touching his asshole and then touching around my pee hole, and then stroked it. Did it a few times. 1)If they indeed did have some stool and blood from their asshole and then touched directly into my penis whole, what is my chances from hiv from these encounters??
Also I know you guys hate talking about symptomes, but On Thursday January 15 exactly two weeks on the dot after the encounter my symptoms have been horrible for the past 3,4 days it started with sore throat, a horrible dry cough, horrible body aches, alot of doing number 2 and stomach issues, and possible swollen lymph nodes in armpits and on my neck. Possible fever, even my gf said My body felt weirdly hot. And I am seeing some weird redness around my chest and upper arm areas. I am freaking out.
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Edward W. Hook M.D.
1 months ago
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Welcome to our Forum. Thanks for your questions. I’ll be glad to comment. The encounter you describe was low risk. You do not know that your partner has HIV, and most People, even those who are transgender do not. Further, Even with dental work present, deep kissing is virtually no risk for HIV, as is receipt of oral sex and condom protected anal. I don’t have an explanation or thoughts on why he kept touching his bottom bot even with blood it would not be an effective means of HIV transmission- HIV is not transmitted through transfer of blood or secretions on a person’s hands to another’s genitals.
The flu-like illness you describe has the characteristics of the HIV ARS and the timing is correct but the same symptoms are also characteristic of numerous other far more common viral infections such as influenza ( rates are currently high), COVID and other illnesses. In studies of persons with symptoms such as yours, over 99% of those persons have something other than HIV. To put your concerns about HIV to rest, I suggest you get a test for HIV. A negative test would prove that your symptoms are not related to HIV. Then you can try to ride out your symptoms. EWH
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1 months ago
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Thanks for the fast reply I still have a few more questions and want to make sure I fully understand everything 1) can you explain more on the are type rash you have seen? I saw a few red blotches around my chest area, and some red looking pimples on my back, and by armpits. And believe that around my knee I am seeing a red blotches, also yesterday when I threw up I had redness on both cheeks for a few days
2) If he indeed did touch infected blood/ stool and the whithin 2,3 seconds touch my urethra wouldn’t that be enough to infect me. What about this makes the hand to genital thing not transmissable?
3( as you mentioned I will get tested but I don’t hit the 4 week mark until next Thursday, would that be conclusive if it comes out negative at 4 weeks?
4) I forgot to mention when she was trying to take the condom off she was using the baby wipes that have alcohol on it, could that have made the stuff go through the condom?
5) why do some sites say condoms are only 70% effective and others 80%? How effective would you say it is if it was used properly and in tact. I feel I am infected and my only hope is that I used a condom. There is so much different information online.
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Edward W. Hook M.D.
1 months ago
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1. Not sure what you mean. A rash is an occasional part of the ARS but is non-specific and not necessarily indicative of an STI of any sort.
2. Repetitive. I said it would not result in infection in the unlikely situation that he had HIV. Why do you think repeating the question would change the answer?
3. IT depends on what test you use. Any time after 11 days following your encounter of concern, a HIV RNA PCR test would be conclusive. A 4th gneration test will be more than 98% conclusive at 4 weeks and entirely conclusive at 6 weeks.
4. Thanks for the additional information. It would not have an effect.
5. There is a lot of misinformation found on the internet. Condoms are often used incorrectly, being put on after initial penetration. They break about 1% of the time. When used properly condoms are well over 96% effective.
One follow-up remaining. EWH
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1 months ago
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Dr Hook sorry if some stuff sounds a bit repetitive alot of us on here are anxiety driven so bad. I have never had bad anxiety. But the timing of the symptoms are driving me insane. It seems as though my dry cough, slight chills, and fever have all but mostly left. But I keep having horrible body aches and some join paint, especially when waking up. Even taking pain killers isn’t helping it much1)Especially this feeling in my lower back, that reaches into my groin are any idea what this could be? I have some slight rednesses that come and go around chest bottom part of chest. And now I am seeng pimple like things, that some appear skin colored bumps and others red. It semes to be affecting the middle to right side of my back , close to upper shoulders and back. I seem to have at least 30,40
Type of bumps. 2) i know you say it’s non specific, but I am sure you have seen your fair share or hiv rashes. Does this sound like ars rash? It is not itchy or does not hurt so far. 3) 96% condom effectiveness is way better than what I have seen online. But now scares me a bit still. So if that partner indeed had newly aquired hiv and the condom did not break, you think there is a 4% chance I could be affected even with proper use? Just trying to clarify
4) whats the 4% you think doesn’t make it closer to 99.9 percent since obviously nothing can be 100% in science
5) I am of course going to get an hiv test in two weeks, but if I were your patient with the risks I described, assuming the partner did have hiv and was not on meds. What would you think my chances would be of dodging a bullet this time?
Thanks for the answers btw if I come out negative I am definitely going to be talking to my doctors about prep if I continue to want to do these events, the anxiety is not worth it
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1 months ago
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6) i did foeget to mention one super important thing I had been dealing with balanitis around the time of the encounter, and may have had some small
Open sores/cuts and may have been more vulnerable. I went to a dermatologist to confirm it. Would this change your ourput or my risk factor knowing I may have had open sores on my penis. Very important info I forgot to mention. This includes during the unprotected oral, hand to genital, and protected anal
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Edward W. Hook M.D.
1 months ago
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I believe that your anxiety is far greater than is warranted by your encounter. Even if your insertive anal was unprotected and your partner had untreated HIV, your risk for infection would be less than 1 in 200 (i.e. there is a 99.5% chance you would NOT be infected. You used a condom and your other activities were no risk, with or without balanitis.
Final responses:
1. The ARS can present with flu-like symptoms such as those you are experiencing but when at risk persons seen in Emergency Departments were tested with such symptoms, 99% of those did not have HIV but some other illness such as influenza, COVID or other common community acquired viral illnesses. The typical rash of the ARS is can be "bumpy" as you describe. As I've already told you, if needed to address your anxiety about the ARS, get a test. I anticipate that it will be negative.
2. See above, descriptions of the rash of ARS vary and are non-specific.
3. The best studies of condom efficacy still rely on self-report regarding both when and how the condoms were used. This may be part of the reason for the 4%. Hard to determine what the rest of the 4% are due to.
4. See above
5. Your chance of having acquired HIV is far less than 1%
6. Open sores are associated with about of 3-fold increase of acquiring HIV be even considering this in the context of your exposure, your risk is less than 1%
I remain confident that you did not acquire HIV but this is clearly eating at you. Go on and get tested now so you can put this behind you. I agree that PrEP might be a good idea for you.
we provide up to 3 responses to each client's questions. This is my 3rd response. There will be no further responses but I will leave the thread open for up to 4 weeks so you can post the results of your HIV if you choose to test. I hope the information I've provided has been helpful. EWH
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