Hey Doctors,I would like to first thank you for the service y'all do for the folks asking questions. It's nice to be able to come here and ask about situations that people have been through and get medically sound and logical advice.On to my situation...

On Nov 5th, I performed oral sex on a guy. I don't know his status. I don't know his name. It was in an adult video theater.  It didn't last long, a total of 15 seconds, with me giving him oral three different times for around 5 seconds. My mouth is in good shape and I don't remember having and cuts or abrasions. I am sure there was pre-ejaculate, but I don't remember him ejaculating in my mouth.

I woke up on November 7th, with a scratchy/sore throat. It stayed like that all day. I'm pretty sure there was nasal congestion because my nose was stopped up. I also am unsure if my lymph nodes were affected, but when I stretched my neck up it hurt down the middle of my neck/throat. There was no fever that I'm aware of. I remember sitting up and my back was real sweaty, but only my back. I felt pretty decent. Cleared my throat alot that day too. I'm pretty sure this was just post nasal drip. It fits better than ARS...I think anyways...

My questions are the following-

1. Was this the ARS? Could it hit me 2 days post exposure? The sore throat and lymph node thing is messing with my ability to understand it was something other than ARS.

2. What is my risk for HIV, or other STDs?

I'm really concerned and anxious about this whole ordeal. I haven't slept well and it's affecting my work performance, and time with my family. Words of reassurance would be really helpful.I will be going in on Monday for an HIV RNA test (13 days) and then plan on having the 4th Gen Duo test at week 4 and week 6.

Thanks again Doctors for your help!!

Def

Oral sex is very low risk for HIV. Peforming oral sex on an HIV infected male has an average risk of transmitting the virus of 1 in 10,000. That's equivalent to giving BJs to infected men once daily for 27 years before catching the virus might be likely. The risk of other STDs is quite a bit higher. On the other hand, at any point in time, most men don't have active, transmissible STDs. However, this was a relatively high risk exposure; anonymous partners in video parlors probably are mostly high risk.

You symptoms cannot be ARS, which cannot cause symptoms sooner than 7-10 days after exposure. As for other STDs, almost none cause sore throat. Gonorrhea can do so, but oral gonorrhea usually is asymptoamtic.

What do do now? For reassurance, I would recommend a throat swab for gonorrhea (valid any time more than 2-3 days after exposure) and, also for reassurance, blood tests for syphilis and HIV after 6 weeks. I really wouldn't recommend an RNA test in these circumstances, but if you go ahead with that plan, a negative result at 13 days would detect around 95% of new HIV infections.

I hope these comments are helptul. Let me know if anything isnt' clear.

HHH, MD

I will schedule the test for Gonorrhea and Syphilis when I schedule the Duo test at week 4.

Would you not do the RNA test because the risk was so incredibly low?  I'm kind of in panic mode (although don't worry, I'm not go into any anxiety fueled messages; this will be my last until my RNA results most likely), and I'm scared that I just altered my entire future.  Do you feel like, for HIV, I just need to relax?

Thanks again Doc!

Def

I want to thank you again for taking the time to reply to me.

I read over your first reply and still had it in my brain to do the syphilis and HIV testing at 4 weeks for the duo, but I saw you recommended 6 weeks. I'll be doing it at 6 weeks. Thank you for the recommendation.

My HIV RNA test, which was HIV-1 RNA Qualitative, came back as not detected. This is the same as Negative, right? Also, should I be concerned about HIV-2 as this only checked for HIV-1? I want to say I read that it wasn't really all that common in the US, but I just want to make sure. Also, you said the test taken at 13 weeks would be 95% conclusive, right? So there's still a minor chance, at 5%? Should I stop worrying with this result and feel comfortable that my 6 week will be negative as well?

Thanks again for all your replies and your help. It means alot. Have a great day!

Def

I think there's a typo -- you mean 13 days, which was the tining of your RNA test. That's a correct statistic. This does not mean there is a 5% chance you have HIV. Even with no testing at all, the odds you caught HIV were no higher than 1 in 20,000 (and that only if your partner had HIV); a test with 95% detection reduces those odds to 1 chance n 400,000 that you have HIV. Accordingly, there is no realistic possibility your 6 week test will be positive.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. You really needn't be worred at all about HIV:  your next test will be negative.