[Question #1788] please help.

45 months ago
I know that asking repetitive questions pertaining to the same situation is something you guys will not answer, but i'm desperate and just want my story to be heard. I really value your guys' opinion.

One month ago I had protected sex and unprotected oral sex (from me to him only) with a man i was seeing. This happened Friday 1/27. On Wednesday 1/25, I came down with a cold (runny nose and congestion) before the incident . Fast forward, Monday 1/30 I woke up with a severe sore throat and mild fever. Went to the doctor and was tested for strep but it was negative. Doctor said it really did look like strep or tonsillitis and gave me amox-clav. After a 1 & half days, my symptoms were gone. However, after i was done with my medicine the white spots were still on my tonsils, but NO symptoms or sore throat. Doctor gave me keflex to clear up the white spots and it went away in a few days. 

This wednesday i came down with an illness. It started with post nasal drip and then the end of my nose cavity (where nasal drip comes out of) started to become sore. Today I woke up with a sore throat but i can't tell if it feels like strep/tonsillitis like i had last time. I drank hot coffee in the morning and my sore throat went away so i kept drinking hot liquids through out the day. Then this evening i got a cough and it feels like something is stuck in my throat. When the night hit, i started to lose my voice. I looked in the mirror at my throat, and i have white spots on my tonsils & i have two white/yellow lines going down the side of my throat, one on each side. Post nasal drip perhaps caused by mucous? Now i am freaking out. I'm afraid I have HIV or hsv 2 in my mouth from performing oral sex on my partner without a condom.

Questions:

1.) Do you think my first illness with the white spots on my tonsils was hsv 2, even though my symptoms resided after 1 day & a half?
2.) Do you think I have hiv since i'm sick 4 weeks post exposure?
3.) Do you think the second illness is hsv 2 or hiv?

Edward W. Hook M.D.
Edward W. Hook M.D.
45 months ago

Welcome to our Forum.  I'll be happy to comment.  Your exposures are very low risk both for HIV and for HSV.  Protected genital sex is virtually no risk if the condom is worn throughout the event and there is almost no risk for HIV or HSV-2 from unprotected fellatio even in the unlikely event that your partner was infected with either.  The likelihood that your partner had HIV if he did not have sex with other men and was not an IV drug user is far less than 1% and the risk for HIV from performing fellatio on an HIV infected is less than I infection per 10,000 acts of fellatio.  As for HSV-2, oral HSV-2 infections are very, very uncommon and when they occur they typically cause small vesicles on the lips and outside of the mouth, not sore throat.  What is far more likely is that you have a non-STI viral infection which is lingering.  Mononucleosis can do this, so can other community-acquired, non-STI viral infections that circulate in the general population.  Neither HIV nor HSV are associated with tonsillitis or laryngitis.  I suspect your current, lingering symptoms are not related to the exposure you mention above but are coincidental. thus, to specifically address your questions: .

1.) Do you think my first illness with the white spots on my tonsils was hsv 2, even though my symptoms resided after 1 day & a half?

No, I would not be worried about HSV-2 in this situation

2.) Do you think I have hiv since i'm sick 4 weeks post exposure?

No, see above.

3.) Do you think the second illness is hsv 2 or hiv?

No.  Realistically I see no reason for testing either however if you wish for the comfort that a negative test might provide and choose to test for HIV, the results of a 4th generation, combination HIV antigen/antibody test will be definitive at this time.  I recommend against blood tests for HSV in this situation.


I hope these comments are helpful.  Please let me know if anything is not clear.  EWH


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45 months ago
Dr. Hook,  thank you for your expertise and advice. It was very helpful.

I went to the doctor yesterday and I was negative for Strep and Mono. My doctor gave me steroids for my cough and drainage of mucous to my lungs. She also gave me an antibiotic for bacterial infections- cedfinir or something like that. I sincerely trust your opinion and if you do not believe HIV or hsv 2 is not the problem here, then I will let it rest.

However, last night I had protected sex with a new partner. This time, there was no oral sex from either of us. We had protected sex and grinded with a condom on. We did kiss and I know thats bad, considering i'm sick. I do have hsv 1 orally and my partner kept licking his hand and then using his saliva as lubricant. I examined my partner's penis and private area, and the only concerning thing I saw was dark black (my partner was african american) moles or spots on the very top of his pubic area- just right before where the pubic hair grows. My partner said they were moles and he's had them for years. I touched them and they did not seem to bother him.

Questions:
1) Does my sexual encounter last night put me at risk for any std's?
2) If for some reason i did have hsv 2 orally, could my partner pass it to me genitally by me kissing him, then him using his saliva as lubricant and putting it on my vagina?
3) I cannot get hsv 1 genitally from my partner using his saliva as lubricant, since i've had hsv 1 for years, correct?
Edward W. Hook M.D.
Edward W. Hook M.D.
45 months ago

It sounds like your doctor is being thorough.  that's a good thing.  Just as an FYI, about 20-5% of mono is not detected by the tradional mono test.  I suspect the therapy you reacieved will make you feel better. 

1) Does my sexual encounter last night put me at risk for any std's?
As I understand your post, this sex was condom protected and involved only mutual masturbation with saliva as a lubricant (if this is right, good job- this sort of safe sex will keep you safe).  As such, this was ansafe, no-risk exposure with no risk to you for STI (Just as an FYI, you may have put your partner at risk for HSV-1 by kissing him if he does not already have it). 

2) If for some reason i did have hsv 2 orally, could my partner pass it to me genitally by me kissing him, then him using his saliva as lubricant and putting it on my vagina?
the chance that you have HSV-2 is vanishingly low.  Even if you did however, he could not pass it to your genitals with his saliva.  In general, once a person has a herpes virus infection, they cannot get infected again with that type of virus at a different site (i.e. you cannot get HSV-1 again at another site)..  HSV (or other STIs) are not transmitted in saliva.

3) I cannot get hsv 1 genitally from my partner using his saliva as lubricant, since i've had hsv 1 for years, correct?
Correct.  See my comment above.


EWH


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45 months ago
You are correct, Dr. Hook. Thank you for all of your kind words and helpful expertise. 

The only thing we did that I do not know if you are aware of, is that he grinded on me without his pants or underwear on, but he had a condom on. I believe this is known as frottage or something, but he was wearing a condom, so it was not completely naked. 

Does this put me at risk for any std's?
Edward W. Hook M.D.
Edward W. Hook M.D.
45 months ago

Grinding without penetration ("frottage") is a no risk act.  Even if he had not worn a condom, since there was no penetration, there would be no risk for HIV or other STIs.  This was a no risk event.

As you know, this is my third reply to your questions.  Thus, as per Forum guidelines, this will be my final reply.  This thread will be closed in a few hours.  I hope my comments have been helpful to you.  Please don't worry and continue to practice safe sex.  EWH

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