[Question #13920] New oral exposure
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3 hours ago
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Dear Dr Hook / Dr Handsfield, I have another enquiry regarding insertive oral. On 9th March i received an unprotected BJ from a CSW in Bangkok. it took nearly 10 minutes to finish with some masturbation which may have caused some micro trauma. about a week later, i felt slightly unwell: dizzy and mildly feverish for a couple of days. More alarmingly i felt a stinging pain in the right side of my penis. 3 days later, it was red and weeping at the sulcus area of the foreskin remnant (i'm circumcized) and in 2 days it had also started on the other side of the penis just beind the head. i figured it was some kind of balanitis due to a fungal overgrowth. I guessed it was probably related to the BJ the week before. it's a tricky area to treat as it is closed most of the time and moisture builds up. it seems to be healing almost a week after applying clotrimazole / betamethasone. in your opinion, could this be due to the sexual activity? i've started having some fears of hiv, due to also having developed a small mouth ulcer on the lower back of my gum, and now i have aching thighs for a few days now and what seems to be an upset stomach (mild gastritis). I remember you stressed how low the risk of this activity is, although i'm just so worried about this bundle of strange symptoms. i know from prior experience that some of these symptoms can maybe be put down to stress, but the initial infection suggests some kind of lowered immunity.
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Edward W. Hook M.D.
2 hours ago
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Welcome back to the Forum. It's difficult to say what your current illness might be although I'm confident that it does not sound like HIV which I know you worry about. As you know from our past exchanges, you can prove this by getting a 4th generation HIV test at this time- if your symptoms were due to HIV, the test would be positive.
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Regarding the inflammatory process involving your penis, there are more questions than answers. You could certainly have balanitis which is now responding to treatment - that's the most likely diagnosis. The other outside possibility is that the weeping lesions you experienced could be herpes although this is unlikely. Certainly any weeping, inflammatory lesion could be herpes although I'm skeptical that this is the case. These are the reasons that I doubt that this is herpes:
1. Virtually all initial herpes lesions appear within 9 to 10 days of an exposure- none of us has ever seen someone how developed herpes lesions beyond 10 days and in most occasions, this happens at 5-7 days. Your weeping lesions were detected rather late to be herpes.
2. When persons develop genital herpes from receipt of oral sex the infection is almost always due to HSV-1, not HSV-2. If you get cold sores, you could not have acquired genital HSV-1 due to the immunity from previous infection. If you do not know you have HSV, there is still a greater than 50% chance that you have HSV-1.
What to do. As I mentioned above, you can get a 4th generation test for HIV and prove that this is not HIV. If you wish to pursue the (low) possibility of HSV and lesions/irritation is still present, a PCR test for herpes may be helpful.
I hope this information is helpful. I am confident that this is not HIV and doubt that it is herpes. If there are further questions, you have up to 2 follow-ups. EWH