[Question #3092] HIV question

38 months ago
On the 30th of November (technically early the following morning), after a night of partying in Las Vegas, in a moment of weakness returning to the hotel I got side lined into a massage parlor.  The summary of it was a blow job by a woman (Mexican/Lebanese descent or so she told me) with condom on, vaginal sex with condom on (she on top) on a table, from behind leaning on table, and then myself on top).  I trouble finishing as I drank too much.   I cannot remember if she took at the condom off - somewhat foggy, but I believe she did.  I do remember struggling to finish.   Anyway 2-3 days later sick.  Have been sick now since.  Sore throat, headaches, congestion (nose and throat), upset stomach (gassy), fatigue (just tired, but I don't know if this is depression), pain under my armpits, chalky dry mouth (particularly the top of my mouth and beneath my tongue), etc.  Am extremely nervous.   Am going to check some tests done this week.  Any thoughts?   Am trying to keep in mind my entire family is sick right now with bad coughs, runny noses, etc.  Am so angry with myself as it seems this is a pattern when I drink.  Bad decisions.   Let me know.  thx.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
Welcome to the forum.

There is almost no chance you caught HIV or that it explains your symptoms. You really needn't worry about it. First, it is statistically unlikely a partner like yours has HIV, probably under 1 chance in a thousand and for sure no higher than 1% (1 in 100). Second, oral sex is safe sex in regard to HIV:  even without a condom, there has never been a proved case of HIV transmission mouth to penis. (A published risk estimate by CDC concludes roughtly one chance in 20,000 if the oral partner is infected. That's equivalent to receiving BJs by infected partners once daily for 55 years before transmission might be likely.) Third, your symptoms started too soon:  acute retroviral syndrome (ARS, i.e. initial HIV infection) cannot start sooner than 7-8 days and generally it's 10-15 dyas. Finally, the symptoms are wrong:  although ARS can cause sore throat and headache, it does not cause nasal congestion. Your symptoms are typical for a garden variety upper respiratory infection; far more likely than HIV is that you have the same cold running through your family, as you suspect yourself.

From a medical or risk standpoint, I don't even recommend HIV testing. There is simply no realistic chance of it, and for the same reason I am confident it is safe for you to continue unprotected sex with your regular partner. However, if you remain nervous about HIV despite this advice, you could consider being tested for it -- i.e. if you will gain additional confidence from a negative test result. If so, you'll have to wait 4-6 weeks for accurate testing. Even if you do it, I don't think you should hold of on sex at home for that long. There really is no realistic chance you have HIV and shouldn't be worried about it.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
FYI, that's 4-6 weeks from exposure for HIV testing, i.e. a couple weeks from now. And I stress this does not mean I really think there was any risk. Testing would strictly be for reassurance from the negative result.

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38 months ago
thx.  just a few things: a.) want to be clear that I did have vaginal intercourse (i.e. it began as a blow job with condom on).  Does your response remain the same?  I guess my worry is even with the condom on, perhaps because I did not finish as quickly as normal, something went wrong?  I don't know.  It was 5AM in a semi dark room.  Things can happen.  I guess i am reaching due to guilt?  I also recognize based on past experiences that my mind can play tricks on me (i.e. make me believe I have symptoms when I do not, hence I am trying to remain calm.  That said, when would you recommend getting tested all STDs including HIV?  Other point, headaches comes recently as did the armpit pain.  Headaches can be very bad.  Intense, but I again, who knows maybe this is just stress?  Same thing with the armpit pain.  Thoughts?  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
Sorry, I should have commented on the vaginal sex as well. But it doesn't change my assessment:  the low chance your partner had HIV plus the effectiveness of condoms amount to a virtually zero risk event.

Congratulations for your level headed, objective self-analysis:  indeed anxiety can magnify trivial symptoms or normal body sensations. In any case, neither headaches nor pain (anywhere in the body) are symptoms that suggest HIV.

The risk of certain other STDs is higher than for HIV, but still very low, and here too, testing is optional and mostly for reassurance. If you decide to be tested, I would limit it to a urine test for gonorrhea and chlamydia (valid any time 3-4 days after exposure) and a syphilis blood test at 6 weeks. Here too you definitely can expect negative results.
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38 months ago
Hi there.  Just wanted to update you.   At this point most consistent issues:  head cold/nasal congestion, semi sore throat, arm pit pain/groin pain (very bothersome); less so odd chest and back pain.  I did speak with my GP, she has agreed on a full set of tests this weekend (the 3 week point); the doctor also wanted me to see a psych which I am arranging a time/day as well.  Am on edge and don't think I will be able to relax until the first tests are done.  Am angry that i got myself into this.  Praying that this does not end up badly.  I hear your points which I thank you for commenting on.  I guess why I am so worried is this place was a real hole in the wall?  Nothing seemed legitimate in retrospect (it was a regular local dental business that had this massage parlor operating a night).  Makes worried that the CSW I was with.   Am stressed.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
38 months ago
Thanks for the follow-up. Neither HIV nor any other STDs cause cold symptoms like nasal congestion or pain in the chest, back, or armpits. Some people read about lymph node inflammation and assume it may cause groin or armpit pain. It does not, without easily felt enlarged nodes; and the lymph node inflammation associated with these infections generally is painless.

I don't think I can help further at this point. Based on all you have said, I'm inclined to think your GP's advice to see a mental health professional makes a lot of sense.

That concludes the two follow-up comments and replies included in each question and co concludes this thread. I hoe the discussion has been helpful. Stay mellow going forward:  I'm confident you have no significant infection from the sexual encounter described.

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