[Question #6729] Hiv scare protect anal

14 months ago
Yes so let me start my story, I live In Miami and about about 5 days ago I had protected anal sex with a male(transvestite),l that is 39 years old, we both gave each other oral no ejaculation, and I also licked his asshole for about 20 seconds, I ended up ejaculating while still inside  but inside the condom, I was only the top not the bottom, and I asked before hand if they were clean, which they said yes, but they could easily lie. (They were also the one to put lube on the condom on 2,3 different occasions before I went inside again) after I went to the bathroom and looked at the condom, and saw no obvious breakage, but saw something slimmy on the til, which I don’r remember seeing before , and there were 3 ,4 different slight red spots on the condom, apart from each other, i’m assuming it’s slight blood, I couldn’t make out if it were inside or outside the condom, I just wanted to take it off and wash my penis and hands immediately., it is now 5 days post and I started getting a sore throat(even see some white spots on tonsil, and my two side lymph nodes are clearly swollen, and My head is a bit hot, I feel I am beginning ars symptoms (even tho I know that’s not the best way to determine if you have hiv)
1) What is the chances I acquired hiv from this event? I feel so stupid for not seeking out pep
2)What is the chances I acquired hsv2 from what I described above? 
3) What are the chances I am in the beginning stages of ars symptoms? 
4) Is there a possibility of getting hepatitis C from licking a butthole, if I get fesces or blood in my mouth? 
5)could the condom have been tampered with by the lube? Like maybe it made a hole or a few small holes on it? 
6) could the blood have gone inside the condom? Maybe when he was on top, it slid up a bit?  


14 months ago
Doctor I left out one thing, and I hope this doesn’t count as a follow up, 32 days prior to these symptoms I also had protected sex with this partner, oral done, but I only did top with a condom. 
7) do you believe that this could be ars 31,32 days post exposure? I am freaking out my neck lymph nodes have never been this swollen, they are pretty tender(and I have had scares before) never felt the lymph nodes  like this
Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

Welcome back to the Forum.  I am stuck by how similar both this encounter and your questions are to the exchange you had with Dr. Handsfield about a month ago.  The answers will be very similar.  I’ll start by just copying the first part of Dr. Handsfield’s reply to you and then go straight to your questions:

 

“You correctly understand that anal sex in men who have sex with men (MSM) is the highest sexual risk for HIV. That's because a far higher percentage of MSM than heterosexuals have HIV (in the US and western Europe), and because anal sex is inherently riskier than vaginal sex. However, the HIV risk is a lot higher for the receptive than the insertive partner; the average risk for you wasn't much higher than vaginal sex, if either partner had the virus. But more important, HIV cannot be transmitted through an intact condom -- and it sounds like you had no other risky events. (Oral sex is nearly free of HIV risk.) Once you made a decision to have such a sexual experience, you did it with maximal safety (congratulations for that wise decision!).”

 

Now your current questions:

 

  1. What is the chances I acquired hiv from this event? I feel so stupid for not seeking out pep

    Your chances are low.  Condom protected sex is safe sex and there is no known HIV risk from rimming.  Rather that going for PEP, as this is a repeating theme, you might consider seeking PrEP to reduce your risk for HIV.  I would suggest you discuss this with your own doctor or a public health HIV specialist.  There are many in the Miami area.

 

2)What is the chances I acquired hsv2 from what I described above?

Also very low for the same reasons.   You used a condom.  You do not have lesions.  Acquisition of oral HSV-2 is very, very rare.

 

3) What are the chances I am in the beginning stages of ars symptoms?

Same answer.

 

4) Is there a possibility of getting hepatitis C from licking a butthole, if I get fesces or blood in my mouth?

Hepatitis C is acquired through needlesticks and only very, very rarely through sex.  Your condom use would virtually eliminate risk for hepatitis C from receptive rectal intercourse which is the main way hepatitis C is acquired sexually.   Ingestion of feces of blood is not a known risk for hepatitis C

 

5)could the condom have been tampered with by the lube? Like maybe it made a hole or a few small holes on it?

When condoms break, they break wide open leaving no doubt that they failed.  I would not worry about condom failure or be paranoid that the lubricant used for your encounter was tampered with.

 

6) could the blood have gone inside the condom? Maybe when he was on top, it slid up a bit?

No.  As before, you are worrying about non-issues. Your condom remained intact, the blood was on the outside. 

 

7. do you believe that this could be ars 31,32 days post exposure? I am freaking out my neck lymph nodes have never been this swollen, they are pretty tender(and I have had scares before) never felt the lymph nodes  like this.

For the ARS to occur more than a month after an exposure, particularly after your earlier low risk exposure is very unlikely.  If you are concerned, an HIV test at this time would be positive if you were experiencing the ARS.  I would expect that, if you choose to test, your test will be negative. 

 

I hope that these replies are helpful.  Consider PrEP.   EWH


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14 months ago
Thank you for the quick response, yes Doctor I had spoken to Dr Hhh and was pretty relieved by his responses for the past two weeks I didn’t even think about this anymore, until yesterday when I started developing a sore throat which has gotten worst today, and I have a lot of white stuff on my tonsils, I do remember havin tonsilits once about 4 months ago, and it felt like this maybe I have it again, just the timing, and the fact that my lymph nodes weren’t this tender that last time is what has me scared , they are super super tender, hoping it’s jjust tonsilitis again, as I heard it can cause swollen lymph nodes and fever( which are identical to 3 maing hiv symptoms) but for my follow up I did want to ask you guys some specific questions as well? Maybe not just 100% to these incidents but something that I am curious about since I will continue to be sexually active (with condoms of course) 
I know that obviously hiv is more riskier with mak but , I feel I have never seen answered , what if I had anal sex with a woman who was hiv positive
1) If viral loads were the same and I had unprotected anal sex with an hiv positive female and male , are the chances the same I would be infected with hiv? Or less with the girl?
2) Also same question but with vagina over anal, considering both are hiv positive same viral load, would I be more at risk with the anal sex?
Lastly more to this event: I know it’s frowned upon and you drs and may people kind of just shrug ars/
Symptoms as non important( and rightfully so), 3)but when ars occurs, or when you have usually see it occur when you you usually see it happen?(there is so many different things online saying days to weeks(the days part scares me) then some places saying 2-4 weeks after, and others saying 2-6?
4) Similar to the question above, Have you ever see ars occur a week or before? How about after 4 weeks? If so is it often(I know you guys hate symptom questions as testing is the golden standard for knowing if you have hiv or not, but what is your opinion on this?
14 months ago
I missed this question thought it went thru
5) can you describe the soar throat associated with ars? Does it also cause white stuff/pus on your tonsils or throat? Or is it just a real sore throat without any white stuff? 
Edward W. Hook M.D.
Edward W. Hook M.D.
14 months ago

I suspect your sore throat is coincidence, nothing more.  It is that time of year. Further, white exudate in the throat is not typical of recently acquired HIV.  In answer to your other questions:

1) If viral loads were the same and I had unprotected anal sex with an hiv positive female and male , are the chances the same I would be infected with hiv? Or less with the girl?
For insertive rectal intercourse with an HIV infected woman, the risk for acquisition of HIV is about the same for vaginal sex, for rectal sex and for insertive rectal sex with a male who has HIV and the same viral load.

2) Also same question but with vagina over anal, considering both are hiv positive same viral load, would I be more at risk with the anal sex?
See above

Lastly more to this event: I know it’s frowned upon and you drs and may people kind of just shrug ars/
Symptoms as non important( and rightfully so), 3)but when ars occurs, or when you have usually see it occur when you you usually see it happen?(there is so many different things online saying days to weeks(the days part scares me) then some places saying 2-4 weeks after, and others saying 2-6?
We really don't "shrug off" the ARS but it is just not that common.  Further, many of our clients worry about the ARS when the have non-ARS symptoms such as a cough or isolated fever.  When ARS occurs (about half the time HIV is acquired or less) it typically occurs between about 10 and 21 days, it sometimes occurs a bit later, out to a month but almost never after 4 weeks.

4) Similar to the question above, Have you ever see ars occur a week or before? How about after 4 weeks? If so is it often(I know you guys hate symptom questions as testing is the golden standard for knowing if you have hiv or not, but what is your opinion on this?
No in both cases. 

5.  The sore throat occurring with the ARS is quite severe and associated with high fever and muscle or joint aches.  The throat typically is red but does not have white exudate.

Hope this helps.  EWH
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13 months ago
Thank you so much doctor i Am completely over this incident, but as my final follow up, I guess I will tell you of an incident that just happened(and I will take your advice of prep very soon, if I continue my actions) but I had sex with another tranny/ male 2 hours ago, same situation, it was protected, and I didn’t even do oral on them(out of fear) but I received oral. That is not as much my worry but for the first time in my life, they ate my asshole, and also fingered me a few times(at least 6 times) and every time, they touched either their penis before hand(mosy probably had pre cum since they were turned on, or they spit on their hand before hand, I know for a fact I can get pap tomorrow before 5 pm eastern( that would be whithin 36 hours of the incident.
1) Do I need pep for that(I will only take it if you feel necessary)
2) Does touching pre cum, and instantly fingering my asshole cause an hiv risk? If so how much perfent? Similar to question one, should I take pep for this?
3)how about of they licked my asshole and had
Blood on their tongue, what percent  of hiv risk is their?
4)Broken record question, but might as well , is their any risk of the two protected sex encounters here?, Same person, but user two condoms on encounter
5) Could I have infected myself, after taking off first condom, and then putting on the other?
6) how long does hiv last outside the body? Or if you have it on your hand, to transmit it to another part?
Thank you once again to you amazing doctors, you have no idea how much you save us, I would not want to take pep unless completely needed to
13 months ago
7) also after I took off the condom (possibly exposing myself)I didn’t immediately wash my hands after, as I hadn’t finished, and played with myself until I came, is that a risk? 
Edward W. Hook M.D.
Edward W. Hook M.D.
13 months ago
Final answers.  What you describe- receipt of oral sex, receipt of analingus, and anal masturbation are all sex acts for which there is no known risk for HIV as no one participating in these acts has been proven to get HIV from them.  That your partner touched their own penis and may have used ejaculate, pre-ejaculate, or saliva as lubricant does not change this assessment.

1.  Taking PEP is a personal decision. Where are you, in this situation I would not take PEP.
2.  See my comments above.
3.  Same answer
4.  My response has not changed for this repetitive question. Correct and consistent condom use use throughout the sex act when the kind of does not break is safe sex. In situations of the sort pep is not recommended.
5.  No
6.  There are no instances in which HIV has been transmitted on one person’s hand to another person and led to HIV infection. The virus becomes non-infectious outside of the body.
7.  No

As we both know, this will be my last response as part of this thread. You have demonstrated a pattern of repetitive risky encounters. Thus far you have successfully taken steps to reduce your risk however in my opinion the frequency and nature of these encounters suggests that you would be a good candidate to take prep. Please strongly consider this. Taking prep as recommended will virtually eliminated your risk for acquisition of HIV.
Take care.  EWH
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