[Question #642] Unprotected oral sex

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103 months ago
Helllo dr HHH

I am getting confused day by day and still wanna get some doubts clear, sorry for the trouble again. 

1) as i asked u earlier about my exposure, now there is high probability that she is hiv poz, because i called her and asked about her hiv status and she didnt say anything and cut the call.  and if she is  hiv positive then also do you consider my 4th gen ag/ab test conclusive on 27th day (26 days +13 hours) after exposure?

2) i have read that (baash )reccomends that testing at 4 weeks is highly likely to exclude hiv infection and recommend re-testing at 3 months because it can exlude hiv-2 type infection and other types. 

3) i am also confused about the methotraxate drug that i am using and i have poroisis and now i am confused with hiv rash and poroisis. I have red spots on hand and chest but not raised. 
And i still have 3-4 red bumps in back of the throat for 2.5 weeks and i have taken allergy medicine but it didnt resolve.

4) now taking all into account what do you reccomend me if the girl has hiv and my unprotected oral exposure on her? Would you still consider my test result conclusive or another testing is needed?

5) I talked to my GP and he said that he is 99% sure that i didnt catch hiv and to be 100% sure you have to retest at 3 month mark. What would you suggest?

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Edward W. Hook M.D.
103 months ago

Welcome back to our Forum.  Dr. Handsfield and I answer questions interchangeably and today I happened to pick up your question.  Before beginning to answer this question I reviewed your earlier interchange with Dr. Handsfield and agree with all that he said.  The encounter you described was a no risk event- condom protected sex is safe sex and no one has ever been proven to have acquired HIV by receiving oral-penile oral sex or cunnilingus.  You are not going to be the first.  Further, as Dr. Handsfield already told you, your 27 day test result is reliable and should be believed.  I see no medical reason for further testing but would understand if your anxiety might lead you to re-test.  If you do, please only do so once - the results will not change with repeat testing.  With these background statements I will now address your specific questions:

1.  That she hung up on you does not mean that she is HIV infected.  Rather she may have been offended by your question.  Irrespective however, as I mentioned above, your exposure was no risk and your tests prove you were not infected.

2.  The recommendations you mention are conservative.  American commercial sex workers virtually never have HIV-2 and your results were reliable.

3.  If your rash were due to HIV at the time you were tested, your test would have been positive.  You appear to be overthinking this and, as a result, are likely to be noticing things that have been present for a long time and are not related to HIV.

4.  I am more convinced than your GP but to be honest, for any individual there is no meaningful difference between 99%, 99.9% and 99.99%, etc.  I am confident that you did not get HIV and, as I said above, I see no medical need for further testing.  if your anxiety would benefit from another negative test, then get tested again with another 4th generation test but only do this if you can be confident that you will believe the negative test result when you get it.

I hope my comments are helpful to you.  I understand that exposures with CSWs can make a person nervous.  Please try not to worry however, your sex was safe and you did not get HIV from the exposure you described.  EWH

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103 months ago
Thank you very much doctor. But u didnt answer my 4th ques that  even if she is positive than also there is no need for testing? And if i want another test what is the best time for that, so tgat i can be 100% sure that i am not infected. Your comments clam me down a little bit. 

And also are these symptoms in my throat related to ars which is still there for 2.5 weeks?
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Edward W. Hook M.D.
103 months ago

I DID answer your question when I said "... I see no medical need for further testing."  this is the case whether or not she had HIV.  Your failure to see that I responded is yet another sign that you are over reacting and over thinking this.

Red bumps in the back of the throat are NOT a sign of the ARS.  Further, the sore throat of the ARS does not last for more than two weeks.

Once again-  Please try not to worry however, your sex was safe and you did not get HIV from the exposure you described.  EWH

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103 months ago
Thank you very much dr. I wll do my best to control my anxiety and not thinking much about this. Thank you again for your comments. It was very helpful.
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Edward W. Hook M.D.
103 months ago
You are welcome.  And again, I am confident that you did not get HIV from the exposure you have described.  EWH
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103 months ago
Thank you doctor. I have decided that not to test again and believe my current result and wll not remain anxious about it. Thank you once again.  Your comments helped me a lot and gave me confidence to believe my result.
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102 months ago
Hello doctor,

Today i noticed a ref spot on my penis. It is painless and not raised. Its not on the head or tip of the penis. Its on skin in  middle of penis.  And since last 4 days i am getting acne on my back and face. On and off. Can you tell me what it is and does it has any connection with this particular incident?? Should i test for any std?
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102 months ago
The spot is red purpulish in color. Its been almost 8 weeks since my oral exposure.
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Edward W. Hook M.D.
102 months ago

Our Forum Guidelines allow three replies to each client's questions.  This will be my 4th, and therefore last, post.  There is little reason to think that the discoloration you have noted is in any way related to your exposure nearly two months ago.  Typically any STI that was going to become symptomatic would have done so long before this.  On the other hand, if they look closely enough, most people have spots and blemishes that appear regularly on their skin.  I suspect that this is what you are experiencing.  If it persists or progresses, I suggest you have your own doctor take a look.  I cannot not provide you with a diagnosis over the internet. 

This thread will be closed in a few hours.  Take care.  EWH

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102 months ago
Thank you doctor. So my question is that i didnt check for any other STI rather than HIV?  Which testbshould i take. My last reply and you can close the thread. Thank you and sorry. You can close this thread, i am not aware of policy of 3 replies.
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Edward W. Hook M.D.
102 months ago
I see no need for other testing.  End of thread  EWH
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