[Question #4789] HIV from female ejaculation in eye

25 months ago
Hi Dr, I’m really hoping you can help as I am an anxious wreck right now.

I saw a CSW 9 days ago, there was no penatrative sex however, during the encounter I watched her climax  “squirt” and during this I felt a drop of fluid hit my cheek.  I cannot be sure if any went into my eye I don’t remember feeling any and I never rubbed my eye but I just can’t tell.  HIV status is of course unknown for this woman but for this purpose we should assume HIV+.  I am concerned that As of yesterday I have had the feelings of a sore throat coming and feeling a few aches. Really scared that this could be ARS beginning and that I have acquired HIV. I am so scarred I cannot  even begin to tell you

I am so scared that I planed to take a PCR qualatitive test tomorrow  (day 10) In the hopes of finding some relief from the worry but also scared to death that it will return a positive result. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
25 months ago
Welcome to the forum. Thanks for your question and your confidence in our services.

First, it is statistically very unlikely your partner had HIV. In most of North America and western Europe, under 1% (and mostly under 1 in a thousand) female CSWs has HIV. Second, you may not know that female "ejaculate" is a squirt of urine -- and urine never transmits HIV, probably not even if it also contains genital fluids or even blood. Urine inactivates many bacteria and viruses and is not a source of HIV transmission. As for your symptoms, ARS doesn't generally cause the subtle sorts of feelings you describe.

All things considered, I'm very confident you don't have HIV. If you were in my clinic, we would not do an HIV PCR test, even if you requested it, and I recommend you just accept the strong evidence you aren't infected. But of course you are fee to do that if you will find the negative results more reassuring than my words. If you go ahead with testing, you can definitely expect a negative result. If so, you should also have a follow-up 3rd generation antibody tests, or 4th generation (antigen-antibody) blood test 4 weeks after the event, to provide 100% conclusive evidence. But truly it isn't necessary. If I were advising someone personally close to me, or if somehow I were in your situation, I would not be tested and would continue unprotected sex with my wife without worry.

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

HHH, MD
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25 months ago
Hi Dr,

Thank you for the previous reply, it certainly helped.

By way of update, I did decide to do the PCR test - in fact there were 2 (this was not intentional and was a bit of a nightmare to be honest and in part, I wish I could have taken your advice regarding testing). Thankfully both tests came back ‘Not Detected’  one was a Genexpert qulitative test and the other was the Roche Multiplex (which has a LoD of <40 copies per ml) also a qualitative for HIV 1&2.  Both tests were taken at 12 days post possible exposure, I wondered what your thoughts were on the timing of those tests and whether you feel the reults are of any value (I know that the gold standard of testing is a duo test at 4-6 weeks). I am still concerned with various symptoms that i’m currently experiencing, the body aches have gotten a little worse with pain in my lower back - feels like it sit’s over a lymph node, low level headaches and my throat keeps drying up leading to soreness.

I’m sure that if I didn’t feel unwell, I’d Be a lot less worried and would ride out the next  week and a half (today is day 17 since possible exposure) fairly easily until I could get a reliable duo test.

On another point, should I be concerned about any other STI’s due to my encounter?

Thanks in advance for your reply.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
25 months ago
Your symptoms are not typical for a new HIV infection -- wrong symptoms for the most part, wrong pattern of symptoms, and wrong timing, And the test results always overrule symptoms. Even if you had HIV, the negative tests prove HIV is not the cause of your symptoms. And you can also be nearly 100% certain you don't have HIV, regardless of symptoms.

Given the nature of your encounter, as I said in my initial reply, you really ddin't need HIV testing at all. However, since you have started down that path, I'm sure you will remain anxious about it until you have absolutely conclusive testing. It would be great if common sense and expert advice were sufficient, i.e. that my words settle the issue for you. But that's not human nature (and I don't take it personally!). So have a duo test 6 weeks after the event. It will be negative. In the meantime, stay mellow; and continue sex with your regular partner, if you have one.

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