[Question #5610] HIV Risk

74 months ago

On the evening of July 23 I was visiting a spa. In the steam room there were two other males, who started masturbating. I did as well. One of the men sat next to me and inserted his finger into my anus, using his precum as lube. He proceeded to finger my anus until I ejaculated.

Because I had an issue with blood on toilet paper from hemorrhoids the day before I was concerned about HIV. I read most experts say there has never been a documented case spread this way, and I called an HIV hotline and they said I was at no risk given there was no penetration of a penis into my anus and that the virus would have died once exposed to the air even in the steam room. I was ok with this response until yesterday as twice I masturbated and both times at orgasm I encountered a headache that lasted a few moments. This was the first time I had orgasm since the event and this has never happened to me before. When I googled "headache during orgasm" , one of the causes that was listed on several sites was vasculitis which was your immune system attacking your vessels as a result of infection which concerned me.

Do you agree I am not risk for HIV based on my exposure? Would hemorrhoids change anything?

Do you think my headaches during orgasm are relevant or coincidental or connected in any way to an exposure?

When would be the earliest I would experience any symptoms and what likely would they be?

Edward W. Hook M.D.

74 months ago

Welcome to our Forum and thanks for your question, as well as your confidence on our service. I am going to presume that the events you describe took place on June, not July 23. if that is incorrect, please let me know. the events you describe fall into the broad category of safe sex- masturbation, even mutual masturbation in which partners get each others' genital secretions on one another is considered safe sex and there are no proven cases of HIV which have been proven to be transmitted in this way. Similarly and perhaps somewhat surprisingly, the transfer of genital secretions on one person's hands to another's rectum, throat or genitals has not been shown to be a means by which infection is transmitted. I would not be worried about this exposure. that you had hemorrhoids which may have been inflamed at the time does not change this opinion.

I believe the your headache during orgasm was a coincidental event. I have never heard of a headache occurring in such circumstances.

As far as symptoms are concerned, the earliest symptoms of HIV are the so-called Acute Retroviral Syndrome or ARS which is a severe flu-like illness typically characterized by high fever, severe sore throat and muscle or joint aches, occasionally accompanied by a rash or diarrhea. typically all of these symptoms occur together and are most common about 10-30 days after an exposure. As far as other STIs, such as gonorrhea or chlamydia, these infections might cause local irritation or discharge but in most instances are asymptomatic at the rectum.

I hope this information is helpful to you. If there are further questions, please feel free to use your up to tow additional follow-up questions to seek clarification. EWH

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74 months ago

Thank you for your quick response . First the event was June 23, not July. You said not to worry About exposure and I would like to concur. (?Not sure i truly understand though) Why did the presence of hemorrhoids not change your opinion? It seems that would be an avenue for the virus to enter my system?

I was concerned about the headaches because a possible cause might be my immune system attacking my blood vessels via vasculitis to ward off the new infections.

Since yesterday, I have had a headache at the back of my head and neck feels stiff. Tylenol is taking care of pain though. Is seven days too soon for this to be connected? Would I probably need more symptoms for this to be ARS?

If The type of contact I had would not allow for HIV transmission, why did you provide potential symptoms for syphilis and chlamydia? Wouldn’t the same be true about them as well?

Lastly, If I were to get an HIV test, when would be the earliest I could do it even though it sounds like you would not in my situation. Just want to be clear before i resume relations with my wife

Sounds like I should move on and quit dwelling.

Thanks

Edward W. Hook M.D.

74 months ago

Straight to your follow-up questions:

1. As I and others have already told you, IF your partner had untreated HIV (you do not know that this is the case- statistically it is unlikely), any HIV which got on his fingers would be inactivated with environmental exposure. Secondly, hemorrhoids are not a portal of entry to the blood but a site that blood comes out of.

2. This vasculitis idea is an internet spawned misperception. In HIV on those rare occasions when vasculitis occurs, it does so in established infection. It would be too early for this to occur. Further a vasculitic HA would be unlikely to improve with Tylenol.

3. You would need to have multiple symptoms for this to even possibly be the ARS. High fever, and severe sore throats are central symptoms

4. I provided information on other STIs in an effort to anticipate your further questions and in an effort to be complete (your not very trusting, are you?)

5. If you choose to get an HIV test, a negative HIV RNA PCR at 11-14 days would provide strong evidence that you were not infected. the gold standard test however is a 4th generation, combination HIV antigen/antibody test obtained at any time more than 6 weeks after exposure.

Hope this helps EWH

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74 months ago

Thank you very much for your reply, and I try to be trusting, but I just want to be thorough given the situation I put myself in.

Also, sorry for Googling, you are correct, I was stretching to find something.

My headache went away after 3-4 days as did stiffness. Never had a fever or sore throat which I am sure was due to stress and anxiety.

It is now 16 days since event. Based on your advice , I can move on without testing as the activity I engaged in had no risk for HIV or really anything. Am I correct in that interpretation?

Thank you

Edward W. Hook M.D.

74 months ago

Yes, your interpretation is correct. no need to worry, no need to test, time to move forward without concern.

As you know, this is my 3rd reply and therefore, as per Forum guidelines, this thread will now be closed. Take care. Please don't worry. EWH

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