[Question #1417] HIV transmission through deep kissing with mouth ulcers

45 months ago
Hi, I'm a 38 year old male living in the UK. On Saturday 19th Nov I engaged in deep kissing with a Ugandan woman, HIV status unknown and no idea how long living in the U.K. I also fingered her several times and sucked and licked her breasts. 

At the time of the incident I had 3 mouth ulcers, 1 on the inside of my top lip near the front and 2 on the piece of skin that connects tongue to bottom of mouth, 1 on either side near bottom of mouth. 

My concerns are

 1: HIV transmission through any blood from her mouth into my ulcers or contact between any sores or cuts in her mouth and my ulcers

2: HIV transmission through any vaginal fluid that may have come from my hands to her breasts and then my mouth after sucking her breasts. 

3: I also used my fingers to take 3 individual pinches of cocaine from a wrap about 5mins after I stopped fingering, using the fingers that had been inside her and snorted them straight off my finger. Is there any way of transmission from this?

I'm going out of my mind as my wife and I are starting IVF treatment in the next few weeks and I would hate to pass anything on to her or an unborn baby. 

We go to the IVF clinic for HIV/STD screening on the 13th Dec, 24 days after possible exposure. 

Is this long enough for the test to be accurate? 

Do I need to go for an additional HIV test at a later date?

This is the first time I've cheated on my wife and it's killing me. I couldn't have picked a worse time to do it. 

Thanks in advance for your help. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
Welcome to the forum. Thanks for your question.

Based on the opening information, you are at little or no risk of HIV, which is rarely if ever transmitted by kissing and not by hand-genital contact (fingering etc) or by mouth contact with non-genital areas, including breasts. Even oral-genital contact is risk free for all practical purposes. Finally, I would guess the chance of HIV to be low in a Ugandan woman living in the UK. AS for other STDs, these also were no-risk exposures. STDs are not simply infections that happen to involve the genital area. The causative bacteria and viruses evolved to require sexual intercourse to be transmitted; and for disease transmission purposes, the activities you describe don't count as sex. To your specific questions:

1) While in theory mouth ulcers or inflammation might increase the risk if exposed, kissing has never been proved to transmit HIV; and of course there have to have been billions of kisses between HIV infected and uninfected persons, including kisses in the presence of oral sores or inflammation. All exposures to infected persons mouths is always low risk; among other things, saliva inactivates HIV.

2) Again, no proved cases; and undoubtedly too small exposure to vaginal secretions through this sort of contact.

3) No known risk through this sort of indirect contact either. 

Regardless of your IVF plans, I see no need for any testing on account of this event. However, if you want to be tested for the additional reassurance of the negative results, you can have a urine gonorrhea/chlamydia test at any time. At 24 days, a 4th generation test (antigen/antibody, or "duo") will be over 95% reliable. Syphilis, herpes, and other blood tests are not conclusive before 6-12 weeks. Another option is to contact your casual partner and ask her to be tested; if negative, of course you couldn't have been infected.

But putting it in personal terms, and knowing what I know, if somehow I were in your circumstance, I would not be tested at all, would have continued unprotected sex with my wife, and would not feel a need for testing because of the planned IVF procedure. Don't confuse your anxiety over a sexual decision you regret (which didn't even include real sex) with the medical consequences of it. They aren't the same. Deal with the first part as you need to (maybe discussing with your wife?) but you can safely ignore the latter.

I hope this information is reassuring. Let me know if anything isn't  clear. Best wishes for successful conception!

HHH, MD

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45 months ago
Thank you for your reply Dr Handsfield, you've put my mind at rest. I knew the chances of transmission were extremely low, just needed confirmation from an expert. There are so many conflicting opinions on the internet that I think it can definitely do more harm than good trawling the internet to find the  answers you are looking for. It definitely made my anxiety a whole lot worse. 

Thanks again and keep up the good work. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
Thanks for the thanks. I'm glad to have helped. As perhaps you have found, you can limit (although never entirely eliminate) some of the "many conflicting opinions" by sticking with professionally run or moderated sites like this one, health departments, academic instiutions and the like; and avoiding those run by and for people with certain conditions. As an example, the geatest convictions about atypical transmission modes or symptoms of any disorder are found in among discussions among persons with that problem.

Take care and stay safe.
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