[Question #6767] HIV risk ?

12 months ago
Hello doctor, in february I had protected vaginal sex and unprotected oral with a sex worker. 

1 week after this I went to a dominatrix and she penetrated me anal using sex toys. On the 8th of March I went to the same dominatrix again we used sex toys. In both encounters with the dominatrix the toys were used with condoms and were used only on me and no one else. After use she also washes them.


Today I have noticed my tongue is white and that a small sore/ulcer has developed on my tongue. 


I spoke with another doctor and he says that it’s from HIV. I have become very paranoid and afraid now as from what I have read online all these encounters are usually considered very low -zero risk. Please help me doctor


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 months ago
Welcome back to the forum.

We try not to disagree with the opinions of doctors who have directly examined forum questioners. If your doctor is highly experienced in STD care and diagnosis, his opinion should be seriously considered. However, I have never heard of anyone with a new HIV infection whose only symptoms were coated tongu and/or a single tongue ulcer. While those certainly can occur with acute retroviral syndrome (ARS, i.e. new HIV infection), other symptoms always are present in my experience and in all scientific reports. Without some combination of sore throat, fever, enlarged lymph nodes (in several areas of hte body) and skin rash, ARS is very unlikely. In addition, the sexual exposure you describe sound very safe. You used a condom for vaginal sex; unprotected oral sex is very safe (there has never been a proved case of HIV transmitted mouth to penis); and your description of the sex toys and their use indicates those events also were risk free.

Presumably the doctor you mention is someone you saw in person, right? If so, surely s/he has ordered HIV testing. What test(s) are in the works? However, if that opinion is from another forum or other unofficial conversation, you can discount it. But since the issue has been raised and you're worried, of course you should be tested. A negative antigen-antibody (AgAb, "duo", "4th generation") blood test at this time will put you in the clear in regard to the February event. I would discount the March event with the sex toys, but if that concerns you, have another AgAb test about 6 weeks after that event. Based on everything you have said, I am very sure any and all these tests will be negative.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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12 months ago
Hello doctor,

The doctor was through an online consultation on justanswer. From what you have said, would I be right to  say that my risk of exposure was very minimal to zero,considering the only unprotected act was the oral?

Would you recommend testing given the circumstances and the exposures described and is there any chance that if I do go through with it, it comes back positive?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 months ago
"Would I be right to  say that my risk of exposure was very minimal to zero,considering the only unprotected act was the oral?"

Yes.

"Would you recommend testing....?"

From strictly risk and medical perspectives, you don't need testing for HIV. However, most people nervous enough to come to a forum like this -- and in your case, it's your second online question about this situation -- are more reassured by negative test results than by professional opinion, no matter how expert. (We don't take it personally!) If I were in your situation, I certainly would not feel any need for an HIV test. But if you're going to continue to worry about it, get tested. The negative result probably will help more than anything else I can say.
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12 months ago
Thank you very much doctor for your continued guidance for people like us ! I am satisfied with the answers and you may close this forum!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
12 months ago
Thanks for the thanks. I'm glad to have helped.---