[Question #4570] Transmission/Symptom Question

27 months ago
Please confirm that the insertive guy with oral sex has a ZERO risk of contracting HIV - even if the person giving the BJ was a transsexual and there was blood in that persons mouth.  In your expert opinion, Is there any scenario that HIV can realistically be spread to the insertive partner?

Additionally, if a condom had always been used for vaginal/penile sex, the male has a ZERO risk for HIV?

Also-question about ARS symptoms- what is the lowest temperature that the ARS fever is? I have read that it is above 100 degrees - is there a number that you generally see the temperature at?

If you were living with HIV for 2 -3 years is it possible to appear completely symptom free; or would you exhibit some symptoms?

Lastly, how long does ARS last? Can it last for a few days and then you are fine, or is it more like you are sick in bed for approximately 2 weeks?

Thank you for your reply. I have read your posts for a long time and have tremendous respect for the work you guys do. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Welcome to the forum. Thanks for your question, and for your kind words about us and our services.

Sorry, but I cannot confirm that there is zero risk of HIV from insertive oral sex. The risk is exceedingly low and there are no proved cases of HIV transmission mouth to penis, but that doesn't mean it can neve rhappen. The same is true for vaginal sex and condom use:  the risk is very low, but probably not quite zero from condom protected vaginal sex if the female partner is infected.

There are no precise data on how high a fever might be in ARS. But a body temperature below 100F is really not a fever anyway.

Many people with HIV for 2-3 years (or even 10 years or more) may be entirely asymptomatic. It's not unusual at all.

ARS usually lasts 2-4 weeks, but probably some people have symptoms for only a few days.

If you have potentially been exposed to HIV, you should be tested. That's the definitive proof about whether or not someone is infected. Symptoms and the type of exposure are never conclusive or definitive. So if you might have been exposed, or even if you're only uncertain. nervous, or curious, get tested. It's silly to simply try to figure out the probabilities based on exposure history and symptoms.

 I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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27 months ago
Thanks for replying Dr. HHH. 

My f/u is: does the amount of time the oral sex was performed increase or decrease the chances of infection? In my scenario i was inside the person’s mouth for 15 seconds.  Is this something you would consider risky and would you  suggest testing over?

You said that there has never been a proven  HIV case mouth to penis-this would put the odds very strongly in my favor - is that a correct assumption?

Does the fact that I am circumcised reduce my chances of infection?

Again, I thank you and applaud you for your great work. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
As you might imagine, there is no research on such details of sexual exposure (duration, depth of penetration, physical vigor, etc) on HIV transmission risk. Logically, longer duration probalby raises the risk compared to brief exposure. But it's not possible to guess by how much. I would think a 15 sec exposure would be very low risk.

Yes the odds are strongly in your favor -- I think that's clear from my comments above. (Do you really imagine you would be the first case, after the billions of such events that preceded yours?) Another way to look at it:  One analysis by CDC suggests a risk of HIV from oral sex, from the infected oral parter to the penis, as 1 in 20,000. That's equivalent to having BJs by infected persons once daily for 55 years before transmission might be likely.

Being circumcised reduces the risk of HIV by about 50%. But for a low risk exposure liks this, it makes no realistic difference -- for example maybe your risk becomes 1 in 40K instead of 20K. Both figures are zero for all practical purposes.

Thanks for the kind words!

HHH, MD
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