[Question #3034] Hiv risk gay encounter

41 months ago
Dear Dr, i am a gay male. I am normally prerty careful about having sex. My recent exposure has been bothering me . I engaged in kissing and rimming(getting rimmed) by a male. We also had oral sex(both ways) but with a condom . He said that the condom mighy have torn while i sucked him but i really dont know if it did . It was deep sucking. I have never had anal sex. But this time gave it a try . He wore a condom amd tried to penetrate me but i was not comfortable so we stopped within about 20 seconds ( penetratiom wasnt full and was just at d tip he said ). He also got an hiv combo test about 5 days before the incident and we exchanged our reports ( non reactive ) by the combo test . 15 days after exposure inhave an itchy throat . I also had very low fever since yesterday which comes and goes ( highest its been is 37.1 or 98.8 F) are these hiv ars symtoms ? No other symtoms. Is this low fever related to hiv? Im reqlly worried that what if the condom tore. Please help. I havent been able to focus on anything bcoz of this . What is ky risk ? Pls advise. Thanks 
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Welcome back to the Forum.  I'll try to help.  Several relevant comments.

First, if a condom tore, you would know it.  When condoms fail, they break wide open.  they do not just "leak"  You would have known if if a condom had broken. 

Second, many people use water-based (npt oil pr petroleum-based) lubricants for rectal sex.  It makes penetration easier. 

Third, I congratulate you and your partner on getting tested and exchanging results.  This is a great way to reduce the risk for infection.  Since he had not gotten infected up till 5 days before your encounter, there is little risk that he got infected in the small interval between his test and your encounter. 

Finally, your symptoms are not suggestive of the ARS.  You do not have a significant fever and the ARS is typically characterized by high fever, sever muscle and joint aches and a sever sore throat.  I would not be worried if I were you .  EWH 
---
41 months ago
Dear dr hook , thabks for your response .  My only worry is what if my partner was in the window period ? He says he fekt the condom tore ehile i performed oral sex on him but i didnt see any holes on the top( not dure if it may have torn from the bottom ). Also the anal sex was just a few seconds and that too with a condom . I Am just worried bcoz my symtoms are in line with the timing of the ARS. Is ARS always severe ? Do u reecommend i get tested ? My last test was about 6 weeks back . My only exposure post that has been kissing a male and this exposure i described. Its been 16 days today . Which test do u recommend. Plz advise. Thanks again
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
"What if" he was in the window period is a "what if" questions like "what if" a satellite fell from the sky and struck me.  The question presumes that neither you nor your partner would have looked at the condom and not seen that it had broken (remember, condom breaks are typically obvious- the condoms break wide open).  They represent your anxiety, not reality.  Similarly, trying to determine HIV risk on the basis of the presence or absence of ARS symptoms is silly since over half of persons who acquire HIV do not develop symptoms. a test at this time would tell you if your symptoms (which, as I said are not consistent with the ARS) were due to HIV but would not be definitive.  On the other hand, testing at more than 4 or 6 weeks after the exposure will give you 99% and 100% reliable information regarding whether or not you were infected.  Based on what you said, as I have already told you, your risk for HIV is tiny.  Testing is a personal choice.

HIV is NOT transmitted by kissing of any sort. 

My sense is that your questions represent anxiety more than the likelihood of infection as long as all that you wrote is correct.  EWH
---
41 months ago
Thanks for your reply dr. You are right that i have been really anxious. My partner said that the condom did not tear during anal and he thiught it tore durinf oral but it did not break wide open so i doubt that it tore.  
Also since i am quite anxious and waiting for 4 weeks would be a bit too long , what would be the accuracy of the combo test at around 18 days ? Also do you suggest a PCR test ?  I have bren monitoring my body temperature today as well its been going up to 98.8 degrees F , and then again dropping automatically. 
Also i am just assuming in the worst case that what if he is in the window period and what if the condom didnt work properly.  
For the future is there any way i can be totally safe from HIV or is abstinence the only way . 
Thanks again for your reply .
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Final replies.

A negative HIV PCR test at this time would prove that you were not infected.  PCR tests also have higher false positive rates that currently recommended combination tests.  A combination HIV antigen/antibody test at this time would detect well over half over recent infections, perhaps as much as 90%.

No sexual activity with a partner who has had other partners is100% safe if they have not been tested but the risk from any single exposure is low and is further educed by the measures you took.  Correct and consistent condom use, asking partners about their status and sharing testing results are good ways to reduce your risk for HIV to close to zero. Then you have to believe that they work, something that you seen to have trouble doing.

This thread will be closed shortly.  EWH
---
41 months ago
Thanks dr ... just a final conformation... the low  fever started about 36 hours back. I plan to get tested after 12 hours with the combo test . Would a non reactive test mean the symtoms are not due to hiv? Because on medhelp u said that tests are positive after a week of syntoms and in my case its been just 36 hours . Thanks
41 months ago
Request u to please reply thanks dr
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Repetitive question.  A negative combination test would prove your symptoms are not due to HIV.

You do not listen to advice.  A word of warning, repetitive questions are at risk for deletion without comment.  EWH
---