[Question #3236] Unprotected Cunnilingus with possible STI Presence - HIV Risk?
91 months ago
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Day 1 - Australia
I am male, had passionate
unprotected cunnilingus - 5-10 minutes on a female sex worker, may have
ingested some vaginal fluid. gums are healthy, vagina didn't have any blood. note:
she claims she doesn't have hiv/STIs, and was tested several days before.
Day 2 to Day 10
symptoms include
fever, muscle aches, coughs, stuffy nose, fatigue
Day 11
Blood test came back,
HIV negative on 4th gen machine
Day 12
Tested +ve for
chlamydia - treated with zithromax
Day 13 (current): 1. Body
temp normal-slightly high, 2.Fleeting pain - comes and goes can be minutes or
hours between each event. can be in jaw, arms, thighs, groin, hand, neck, head (most
worried about this) 3.tonsils are slightly swollen, w/ slight sore throat, zero
pain on swallowing but have uneasy feeling, sometimes lumpy in throat
(comes/goes) 4.stuffy nose past 5 days but is slowly starting to clear , 5.pronounced
little dark black marks appeared on upper back/arm, 6.fatigue has reduced
Question:1.What is my
risk exposure level given the above encounter? 2. What % confidence does the
hiv test give? 3. As of Day 13 Given the fact that I am currently under stress/anxiety,
what are the causes of my current symptoms? Is it due to flu/anxiety/other? 4. Given
the detection of chlamydia on day 12, does this suggest I caught chlamydia
before encounter & if so, how does that affect the hiv transmission
probability? 5. I am most concerned about the persistent muscle/body aches, any
possible explanation?
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Edward W. Hook M.D.
91 months ago
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Thank you for your questions. I will do my best to try to help. In some instances, additional information from you may be helpful.
Question:1.What is my risk exposure level given the above encounter?
This was a low risk encounter. Licensed commercial sex workers in Australia are required to get regular STI (including HIV) check-ups and infections in this group are unusual. Further, cunnilingus is a low risk sexual activity which is not “efficient” for acquisition of STIs, even if your partner was infected.
2. What % confidence does the hiv test give?
A combination HIV antigen/antibody test at 10 days will not detect many recent infections, probably in the neighborhood of 40-50%. At 4 weeks the combination tests will detect about 99% of recent infections and at 6 weeks (42-45 days) their results are definitive. HIV PCR-type tests provide reliable answers earlier (12-21 days) but are more expensive and have more false positive test results.
3. As of Day 13 Given the fact that I am currently under stress/anxiety, what are the causes of my current symptoms? Is it due to flu/anxiety/other?
Given your description and the nature of the exposure you describe, your current symptoms are more compatible with a recently acquired, non-STI/non-HIV viral infection than HIV. Cough and a runny nose are not part of the presentation of a recently acquired HIV infection.
4. Given the detection of chlamydia on day 12, does this suggest I caught chlamydia before encounter & if so, how does that affect the hiv transmission probability?
Was this a genital infection? If you only performed oral sex on your CSW partner, then your chlamydia infection was likely acquired from a different partner.
5. I am most concerned about the persistent muscle/body aches, any possible explanation?
Please see comment 2 above.
I hope this information is helpful. If any of this is unclear or you have additional questions, please feel free to use your up to two follow-up questions. EWH
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91 months ago
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91 months ago
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![]() |
Edward W. Hook M.D.
91 months ago
|
91 months ago
|
91 months ago
|
![]() |
Edward W. Hook M.D.
91 months ago
|