[Question #1411] Unprotected Oral

93 months ago

Dear Doctor ,

I am a 30 year old male. And I'm afraid from HIV.

I had two exposures of Unprotected oral (getting a blowjob) on October 1st and October 16th from a CSW . Each lasted less than 5 minutes .

On November 12th and 13th I had mild sore throat , runny and congested nose and mild body aches but without fever . (it's the cold season now ) . The next day (4 pm) I had eggs for lunch and took some cold and cough medicine . After a while I noticed a noticeable rash on my shoulders and upper chest and collar area only . The rash was not itchy and not raised .

I panicked and after 4 hours (8 pm) I went to a dermatologist and he said it's urticaria and said it might be due to eggs or medication , he gave me shots and prescribed some steroids and antihistamine tablets and cream .

I was never allergic to eggs nor to cold medicine .

Next day in the morning the rash cleared 50% and in less than 48 hours it was completely gone .

My questions are:

1. Is there any risk of HIV for receiving blow job ? Knowing that I didn't notice any bleeding from CSW mouth .

2. The time of the rash is after 4 weeks of the last exposure . Is it related or late. ?

3. I didn't have flu like Symptoms no fever no night sweats is this a good sign ?

4. The rash cleared in less than 48 hrs with the injection and some tablets ? Does ars rash clear this quickly ?

5. I read on internet the ars rash looks like hives (urticaria ) and I'm afraid the dermatologist misdiagnosed it. ?

6. Please help me know risks of getting Hiv from receiving Unprotected oral ?

Thank you Dr

Edward W. Hook M.D.

93 months ago

Welcome to our Forum. I'll be pleased to comment. In terms of HIV this was a no risk event. Even if your partner had HIV (even among commercial sex workers, the majority do not have HIV), there has never been a case of HIV documented to have been acquired by receipt of oral sex, not even one. This is the case irrespective of mouth sores, bleeding gums, dental disease in the person performing oral sex. You will not be the first. There is no medical reason to even test for HIV related to this exposure.

Several STIs are occasionally acquired from receipt of oral sex. Nongonococcal urethritis (NGU) due most often to acquisition of mouth bacteria into the urethra is most common and more rarely Gonorrhea can be acquired from oral sex performed by a person with gonococcal pharyngitis. Both of these problems are typically symptomatic, presenting with burning on uriantion or a penile discharge. If these do not occur in the few days after sex, you realistically have nothing to worry about.

With this as background, on to your specific questions:

1. Is there any risk of HIV for receiving blow job ? Knowing that I didn't notice any bleeding from CSW mouth .

Please see above

2. The time of the rash is after 4 weeks of the last exposure . Is it related or late. ?

Four weeks after exposure would be quite late for the ARS to occur - two weeks would be much more typical. When it does, the rash, if present, is typically accompanied by high fevers, severe sore throat and muscle joint aches. Your symptoms do not suggest the ARS to me.

3. I didn't have flu like Symptoms no fever no night sweats is this a good sign ?

This is also evidence that this is not the ARS- see above.

4. The rash cleared in less than 48 hrs with the injection and some tablets ? Does ars rash clear this quickly ?

There is little reason to thing that your rash was the ARS. When the rash of ARS occurs it can be highly variable and typically lasts only a few days. The steroids you took are likely the reason your rash resolved, no matter what casued it/.

5. I read on internet the ars rash looks like hives (urticaria ) and I'm afraid the dermatologist misdiagnosed it. ?

See above, I would not worry about your rash

6. Please help me know risks of getting Hiv from receiving Unprotected oral ?

Again, see above

I hope these comments are helpful. I would not be worried about HIV and see no medical reason for testing. EWH

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93 months ago

Dear Dr.

Thank you for ur reply.

I have one more question : you say receipt of Unprotected oral (getting a blowjob) is no risk for hiv and there is no single case and that I'm not going to be the first. But I have also read some of your replies that u said hiv infection rarely happens through recipet of Unprotected oral.

Please clarify. It's been 6 weeks post exposure and I'm afraid to test and resume sex with my wife.

Thanks

Edward W. Hook M.D.

93 months ago

You are mistaken. I have never said that HIV has ever been acquired by receipt of oral sex. There are no reported cases. There ARE a few cases in which persons PERFORMING oral sex on an infected partner have acquired HIV. That is not your situation. My reply stands, this was a no risk exposure, there is no need to test but if you do, the results will be negative, proving that you did not acquire HIV from the exposure you described. EWH
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93 months ago

Dear Dr,

Many thanks for your reply and support.

I had 2 hiv tests done (4th generation):

1. HIV (1&2 Abs and P24 Ag), serum method ECLIA

2. HIV I&II Abs+ p.24 Ag serum method CMIA.

Both test are negative. And from two different labs.

I had both these tests done at 42 days mark after exposure which is exactly 6 weeks. and 13 days after I had the rash on my chest. And my exposure was receipt of Unprotected oral.

My questions :

1. Are those 2 hiv tests 100% conclusive at 6 weeks?

2. Is there any slight or tiny medical reason to test at 3 months?

3. I tested after the rash happened which was 13 days? If I assume it was ars rash will the test result be positive? Or 13 days after symptoms is too early?

4. Can I resume Unprotected Sex with my wife?

Appreciate ur help and thanks

Edward W. Hook M.D.

93 months ago

Straight to your follow-up questions:

1. Are those 2 hiv tests 100% conclusive at 6 weeks?

Yes, absolutely, 100% conclusive. There is no need for further testing. There results will not change and should be believed.

2. Is there any slight or tiny medical reason to test at 3 months?

No, no medical reason at all for further testing.

3. I tested after the rash happened which was 13 days? If I assume it was ars rash will the test result be positive? Or 13 days after symptoms is too early?

Correct, without a doubt, if your rash was due to ARS, your test would have been positive.

4. Can I resume Unprotected Sex with my wife?

There is no reason related to the exposure you describe for you to avoid unprotected sex with your wife.

I hope these comments are helpful. This is my third response to your questions and therefore, as per Forum guidelines, this thread will be closed later today. Take care. EWH

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93 months ago

One last thing Dr.

What is it that all medical websites say 3 months for window period, please advise 6 weeks ok or 3 months?

Thanks