On June 29th I performed unprotected oral sex on a female partner for no longer than 5mins. My gums do bleed when I brush my teeth and I have medium gingivitis. 2 weeks following the encounter I got a sore throat which started Thursday night and was gone by Friday night. This was followed by runny nose,slightly raise temperature, sneezing and coughing. After about a week I felt completely better. However i’ve noticed I have palpable lymph nodes under my jaw and around groin. Not tender or sore just able to feel and locate them. I’ve also had discomfort in my armpit but cannot feel or locate any lymph nodes. Last week Tuesday I got a red bump on the hard palate of the roof of my mouth. I assumed it was a burn but I’m not sure as I’ve never had a mouth sore before. It lasted one week. I’ve also notice small flat painless blood spots on the inside of my bottom lip that come and go.I know the risk for HIV from oral sex rises with gum disease and bleeding gums. I took a oraquick test 16 days after exposure which was negative and plan to take another at 6weeks and 3months. What is my risk for hiv transmission and am I just being paranoid? Should I follow through with my plan for testing or forego it? Do my symptoms raise any red flags? I’ve had unprotected sex with my long term girlfriend 5 times since the encounter and I’m scared that i May transmit something to her. 

Oral sex, and especially cunnilingus (oral-vaginal) should be viewed as safe sex -- not completely free of STD/HIV risk, but much lower risk than vaginal or anal sex for all infections, and virtually zero risk for some, including HIV. To my knowledge, there has never been a proved case of HIV transmission by cunnilingus. That doesn't mean it never happened, but if so it is very rare. While I suppose gum infammation might raise the risk, gum inflammation is so common that there must have been millions (billions?) of oral sex exposures in its presence, and still no known infections.

And your symptoms are not suspicious for acute retroviral syndrome (ARS), i.e. acute HIV infection. Two weeks is on the long side for onset, and ARS doesn't cause nasal congestion or cough. It sounds like you caught a cold. And self assessment of seeming lymph node enlargements is very unreliable.

So from a strictly medical or risk assessment perspective, you really don't even need HIV testing. But since you're started down that path, you should conitinue until you have a definitive result. I suggest it strictly for reassurance, not because I believe there is any realistic chance you have HIV. Assuming you go ahead with testing, forget the oral fluids self test. Three months is required for conclusive results, and even then, this test isn't really conclusive: it misses 2-4% of HIV infections. Find a doctor or lab for an antigen-antibody blood test (AgAb, "combo", "4th generation"), which is nearly conclusive (98-99%) at 4 weeks and 100% at 6 weeks.

Alternatively, contact the wonan involved and go together for HIV testing. (You may find she is just as nervous about your HIV status as you are about hers.) When you get the negative results, you'll both know you couldn't have infected the other.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Thank you for your response. Just to bel clear the woman whom I had this encounter with was not my girlfriend. It was someone I met while at a out of state trip so going for testing together is not possible unfortunately. 

You’ve that 2 weeks is late for onset of ars symptoms however cdc says symptoms usually show 2-4 weeks after exposure. Can you clarify this?

Secondly are palpable lymph nodes normal? Some sources they shouldn’t be noticeable unless swollen others say slim persons and able to feel their lymph nodes regularly. Which is it?

Lastly do any other STI’s exhibit the symptoms I’ve described or should I be tested for any other STI’s?  I would really hate to give my girlfriend something because of my stupidity. I feel really guilty at the moment.

If you and your oral sex partner can't be tested together, if you have her contact information, you could still tell her your fears and ask if she has been tested recently -- and if not, to perhaps consider it now, and offer to share your own test results.