[Question #414] HIV anxiety from unprotected cunnilingus: Please help Dr.Handsfield

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102 months ago
Hello doctor,

I have been following many many of your answers and posts online.
However, It would help me very much to have your thoughts on my situation specifically.

On September 12 2015, about 4months ago, I had an encounter with a massage parlor worker.
She gave me a handjob and I gave her unprotected oral sex for about 5minutes. (The place does not have sex with people)
About 3 days after this exposure, I got small itchy bumps on my inner arm and chest.
It started to itch a lot and I am not sure if its because I kept scratching but it spread all over my body.
I could not sleep because I was itching everywhere. I am not sure if I had sore throat and fever at this time.
Some were blisters on my fingers. The bumps look something like this (reference):


So I started to get super anxious because I never had this before.
I went to a dermatologist and he said it is eczema, but I have never had eczema before and I am in my mid 20's.
So I kept worrying and being anxious.

On October 22 2015 ( 5 weeks and 5 days after the exposure ) I went to my primary doctor to draw blood to send it to get HIV antibody test from LabCorp. He said that its more difficult to get HIV from cunnilingus than winning a lottery. But I was still very very worried...

On October 24 2015, I received a negative result:
HIV 1/O/2 Abs-ICMA
HIV 1/O/2 Abs, Qual - Non Reactive

I was relieved but even until this day, I am getting 1 - 2 more itchy bumps on my body. On my arm, chest, fingers, neck and back.
So regardless of my 40day antibody negative test, I am still worried for HIV. I check my temperature every day and its always 35-36c.
My throat is not sore but I do develop new itchy bumps every 1-2 days.

Should I get another antibody test now? (4month period)
Or am I just being anxious and unreasonable and should move on with my life?

Please doctor Hna... let me know your thoughts!

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Edward W. Hook M.D.
102 months ago

Welcome to our Forum.  While I would not go so far as to say your are being unreasonable, I would advise you to stop worrying about HIV.  I agree with your doctor that the exposure you describe was essentially a no risk event and that the testing you had at nearly 6 weeks would have detected about 95% of recent infections (even more given  the fact that you were symptomatic).  Further, your symptoms, which began three days after your exposure occurred sooner than would be typical for the ARS.  I urge you to stop worrying that you got HIV from the exposure that you have described and move forward.  I see no need for further testing related to the exposure you described.

Eczematous dermatitis is a common problem which can be worsened by a number of things, including anxiety and scratching.  If this is continuing to trouble you, my advice would be to return to the dermatologist who you saw before and see what he has to say.   There is a certain amount of trial and error involved in management of many problems and the fact that he saw you before may be helpful in addressing the continuing problems. 

I hope these comments are helpful to you.  EWH

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102 months ago
Thank you so much for your answer Dr.Hook.
Do you think its possible for any HIV symptoms to last as long as 3months? (this case eczema-like rashes)
Also, what type of cases/people take longer than 6weeks to develop antibodies?
Has there been a case of HIV infection via cunnilingus in the past?

Thank you so much, Doctor.
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Edward W. Hook M.D.
102 months ago

No, symptoms of recently acquired HIV would not last three months.  further, when test results and symptoms disagree, the test results should be believed. 

Unless someone is taking anti-HIV therapy, it is most uncommon for someone to take more than 6 weeks to develop antibodies.

There are no cases of HIV acquired through cunnilingus that I am aware of.   EWH

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101 months ago
Thank you so much for your answers doctor.
Last few questions...
When you say antibody tests are 95% accurate at 6 weeks and that people who may not have antibodies by 6 weeks are the ones who might be taking anti-HIV therapy, does that 5% apply only to those who already have HIV (Sorry I was a bit confused about this)
Also, is is possible for someone who is not under any anti-HIV therapy to develop antibody later than 6 weeks and develop only rash/itchy bumps as symptoms?

These are my final questions.
Thank you for your time Doctor!
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Edward W. Hook M.D.
101 months ago

The 95% figure at 6 weeks with the INSTI test is a conservative and when considered in the context of an exposure which has NEVER been associated with acquisition of HIV should be considered evidence that you were not infected.  Further, if the rash you describe were due to HIV, the antibody test would be positive at that time.  As for the rash, if you had an HIV-related rash, your INSTI test would be positive at that time and beyond.  There are a small proportion of persons who do not develop positive antibody tests until after 6 weeks but that very small proportion do not have symptoms.

This will need to be the last reply, as per Forum instructions.  You need to understand that you did not get HIV from the exposure you have described.  EWH