[Question #5935] HIV risk assessment

17 months ago
Hello I had an exposure August 17th on a Saturday and woke up the following Tuesday with a sore throat, hot temperature, and a swollen right tonsil. After a couple of days, the sore throat went away but the tonsils remained inflamed and I’m taking antibiotics for it. This past week I’ve been experiencing diarrhea and I had an incident where I woke up an hour after falling asleep and I woke up sweaty. Woke up normal in the morning. I didn’t have a fever or any cold symptoms. 

My exposure was very BRIEF slight insertion from a 20 year old straight Middle Eastern college man.  It was mostly frottage but there was a second where I felt pressure on my vaginal entrance from the head of his penis. I’m not sure if he actually entered and he said he would’ve known if he did and claims he didn’t but for all intents and purposes I’m going with that he did enter with the tip at least for a few seconds (I pulled away immediately). He tested negative in January but has had multiple unprotected encounters with other women (he’s in a fraternity so most likely girls on campus). What would you rate my risk?
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Welcome to the Forum.  thanks for your question.  I'll be glad to comment. The exposure you describe sounds very low risk.  Let me provide some specific comments which may be helpful.

General comments first.  HIV is relatively rare.  Here in the U.S. the rate is only a small fraction of 1% of the population and most infected people are men who have sex with other men or persons who inject drugs.  Your partner sounds to be unlikely to fall into either of those groups.  further he told you he had been tested and was negative and most people do tell the truth.  If he was HIV negative a few months ago it is unlikely that he acquired HIV in  the interval, particularly if other partners he might have had were other college students ( in general a low risk population).

Specific comments:
Your onset of sore throat and feeling feverish is a bit early for recently acquired HIV or, for that matter any STI.  it is far more consistent with the sore of viral or streptococcal infections that are quite common ion college campuses.  Secondly, had he truly achieved full penetration, I think both of you would have known it.  I suspect your exposure is more likely to represent frottage which is a no risk event for HIV.  

I hope this information is helpful to you.  If there are further questions, we provide up to three responses to each client's questions.  I do think this was a very low risk and perhaps no risk event. EWH
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17 months ago
Thank you for your reply. I figured the sore throat and inflamed tonsil would be too early, but what about waking up sweaty about 12 days after the incident? Also what if he came on an ingrown hair/ popped pimple on my chest?
And again I’m not sure if he managed to slightly get in but I do not for sure he didn’t FULLY penetrate as in, insert his entire penis inside me. If he did get in it would’ve only been the tip as I only felt some pressure for sure and moved away immediately. 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
Waking up sweaty is a non-specific event which I would not attach importance to.  When a person gets HIV, all of the symptoms (i.e. fever, sore throat, muscle aches, etc.) all occur at the same time.

Ejaculation on a broken pimple or ingrown hair does not put you at any increased risk for HIV.  I would not worry about it.

As I said earlier, without full penetration, I would not worry about the events you have described.  

Hope this information is helpful.  EWH
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17 months ago
Thank you. I’ve had thigh pain the past two nights and a swollen lymph node on my neck but that started with the sore throat. The sore throat, lymph node, and fever started 3/4 days after the event. And the sore throat and fever felt better almost immediately it’s just the swollen tonsil and lymph node that remain. I’ve have muscle aches on my upper legs this past Wednesday night and now tonight. Last night I woke up sweaty in one instance but not the rest. No flu or cold symptoms. Should I still not be concerned over these symptoms? If he did penetrate me with his tip and there was precum what would the risk be? What tests would recommend for my risk and at what timeframe? 
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
As per Forum guidelines, this reply to this somewhat repetitive question will be the final response to this set of questions.  I have done my best to assure you on the no risk nature of the events you describe.  Coincidental timing, along with perhaps some guilt or anxiety over the contact is unfortunate but has a way of creating great concerns.  I would attribute your symptoms to something other than the contact you described, perhaps amplified by your concerns.  IF he did penetrate you (unlikely), and IF there were genital secretions present on the tip of his penis, and IF he had an STI, they would not explain the symptoms you have and are experiencing.  In such a situation, if you choose to go on and test, I would suggest testing for chlamydia and gonorrhea, the two most common bacterial STIs.  These tests will provide definitive results at this time.

In addition, because of your concerns, I would suggest testing for HIV at this time.  If your symptoms were due to HIV, your test would be positive (Even though a 4th generation, combination HIV antigen/antibody test will not provide definitive results until six weeks after the exposure because some HIV infections are acquired without symptoms, when symptoms are due to HIV, the test is always positive.)

As mentioned above, this thread will now be closed.  Take care.  EWH
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