[Question #7262] HIV risk from fresh irritation on scrotum

6 months ago
Hi. I will say in advance that I know how stupid I am for this incident. It happened 40 days ago. I gave a man a handjob, rinsed my hands with water (semen is thick so it remained on my hands) and then I wiped my hands with paper towel. Then I think I used that paper towel to wipe my scrotum, which I had recently shaved with an electrical grooming trimmer and may have created irritation or small skin openings. I just tested negative with a 4th generation antibody/antigen test at 39 days. I do not know his detailed status but he said he had tested negative to a rapid oral swab at the time, which I have heard sometimes gives false negatives and also doesn’t account for more recently acquired antigens. I am awaiting his detailed blood results but I’m not sure he will share with me. In the meantime, I have been unable to sleep, which I am not sure is a physical reaction to the virus or not. I often panic  uncontrollably throughout the day and I’m wondering if the virus is affecting my hormones or adrenaline. I also have had tenderness in my scrotum (same area of possible infection) and I have been unable to get an erection (or any blood flow) to my penis in weeks. Do you have any insight as to the likelihood of infection? Do you know who might have an answer? Thank you in advance for your attention.
6 months ago
I forgot to mention that I have  night sweats, dry mouth and tingling in my hands and feet.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
Welcome to the forum. Thanks for your confidence in our services.

You needn't worry about HIV. You don't have it. The exposure was zero risk for all practical purposes:  there has never been a known case of HIV transmission by hand-genital contact (nor to my knowledge any such cases even suspected). That's despite the frequent use of genital fluids for lubrication, and despite frequent genital skin rashes or other conditions that might in theory increase the risk. Equallyl important, your negative test result is nearly conclusive; nearly 100% of people with new HIV have positive AgAb (4th generation) blood tests by 39 days. You could consider having another AgAb test after the 6 week mark, but you definitely can expect it to also be negative. 

As for your symptoms, even though your current blood test isn't quite 100% conclusive, it IS conclusive that your symptoms are not due to HIV. It is not possible to have night sweats (or any other symptoms) due to HIV with a negative AgAb test. Your test result overrules both your symptoms and exposure histroy. As for dry mouth, tingling sensations, scrotal tenderness and erectile dysfunction, HIV is not known to cause any of these symptoms.

I'll be happy to comment further if you'd like to tell me the result of a follow-up blood test and/or your partner's test result. But even without those results, you can be very sure you don't have HIV.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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6 months ago

Thanks, Dr. Handsfeld. I know that my test result is good news, but I fear that I am not out of the woods yet.

 

What you are saying about the night sweats makes sense, but what if they started less than a week before the test?

 

I noticed the penis/testicle pain about a week before the test. I have read that penis/testicle pain could be caused by prostatitis, which could be caused by HIV (https://wb.md/3cdelnG). Also in that article, it says erectile dysfunction could be caused by prostatitis or hypogonadism, both of which are linked to HIV.

 

As background, I am 35 years old and have tested negative for other STD’s and UTI. A urologist said no to NGU, as it does not sting when urinating. On very rare occasions, I am able to get an erection but it is painful. If I do have prostatitis caused by HIV, do you think the virus started in my prostate and is just recently starting to branch out to the rest of my body, causing a delay in a positive HIV blood test?  I think you will agree that it is odd for a man my age to be having these issues…

 

Regarding the other symptoms, I have read that numbness/tingling in hands and feet could be caused by HIV neuropathy. I have been experiencing this for more than a week. I have also read that dry mouth is a symptom of HIV, which I only experienced two days before the test (https://wb.md/2Eh1h40). I am not on any medications that would cause this. Also, my stool has been loose in recent weeks.


Going back to the incident itself, I know you said hand-to-genital transmission is very low risk, but what about when you take into account the stupidity of using a paper towel with someone else's semen to wipe down your genitals, possibly exposing their semen to the urethra or any irritations caused by the electrical razor just an hour before the encounter?


Thank you in advance for your consideration to my concerns. I know you are respected in your field, and I am hopeful that you can provide some insight into this seemingly rare situation, based on your research and (I assume) clinical experience with HIV patients.



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
"I fear that I am not out of the woods yet."  That's an irrational, unfounded statement. 

"I have read that numbness/tingling in hands and feet could be caused by HIV neuropathy." It's a fool's errand to read lists of HIV symptoms and conclude you might be infected because you have a few of them. Except for symptoms related to trauma, injury, etc, almost any symptom experienced by human beings for any medical reason can also occur with HIV. Single symptoms, or just one or two of them, almost never denote HIV. The pattern and timing of symptoms are even more important than the symptoms themselves. In my decades in the STD/HIV business, I have never had a patient with symptomatic ARS who did not have some combination of fever, sore throat, lymph node enlargement, and skin rask, all starting 1-3 weeks after exposure. Single symptoms of the sort you describe are to be ignored as evidence of HIV.

The FACTS of your case are are that 1) You had an exposure that has no realistic possibility of transmitting HIV.  Do you really suspect you would be the first world's case among the tens of millions of HIV infections that have occurred? 2) Tingling isn't necessarily due to neuropathy; emotional/psychological explanations are more common in this situation. And anyway, neuropathy is a manifestation of advanced HIV, i.e. overt AIDS, typically after many years.  3) As I said above, your blood test results PROVE that no symptoms you currently have are possibly due to HIV. HIV symptoms are caused by the body's immune response to the virus -- the antibody component of the test denotes an immune response -- and therefore no symptoms due to HIV are ever possible in presence of a negative antibody test, especially one done more than ~10 days after infection.

Finally, if hand-genital contact using semen for lubrication never transmits HIV, how could the same sort of contact on a towel do so?

Maybe you will also be reassured to know that in the 15+ years of this and my preceding forum, with thousands of questions from people worried they caught HIV, not one has reported that they actually were infected. You aren't going to be the first. If and when that finally happens, surely it will be a legitimate high risk exposure, maybe something like unprotected anal sex with a known infected partner.

So do your best to believe and accept the reasoned, science based reassurance I have given you. This is all a big nothingburger!
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6 months ago
Hi Dr. Handsfield,

I am trying to believe your statement that the negative blood test proves any symptoms I was experiencing at the time, such as dry mouth and night sweats, could be due to HIV. Is that true even if the night sweats started roughly five days before the test date? 

Today, I woke up with pain behind my left knee, where there is a lymph node.

I also have a rash on my back, although it looks similar to the tinea versicolor I sometimes have around my neck. I also notice six red dots spread out around the left side of my back, with one more on my left shoulder. I imagine I will see more of these in the coming days.

 I am scared to death, and I am so confused as to how this happened.

Everyone I talk to and everything I have read seems to indicate this experience was a very low risk. Yes, I know it was incredibly stupid for me to use the same paper towel to wipe off his sperm as well as wipe off my genitals. I was clearly frantic and not thinking. But I really don't think I had any open cuts or any contact with the urethra (which I believe I used a separate towel for). Maybe something else happened that I cannot remember, but I don't know what. I'm not even sure I shaved my testicles that day, to be honest.

Some of it may have gotten onto the ridge of my circumcised penis head, but I have heard a circumcised penis glans is not a true mucous membrane. Is that correct? Surely, these hypothetical people using sperm as lube are not stopping short of the penis glans. 

Where are these "reported cases" listed? How many cases are there of people acquiring HIV after getting semen on their penis? 

Also, can you shed some light on the theory that HIV dies as soon as it hits the air? I have seen that line used to dismiss plenty of concerns by users on MedHelp and other forums, but that surely cannot be the case if I am infected.

Yesterday was the 6-week anniversary of the incident. Do you have any idea why the symptoms are so delayed in my case? Did you have any thoughts on the prostatitis/hypogonadism symptoms I mentioned in my last message? (https://wb.md/3cdelnG).

I still have not heard back from the other person regarding their test results. I kind of doubt I will.




6 months ago
I also fear I am beginning to develop a sore throat, although it seems to have a light mucus component to it, which is unlike what I imagined with the throat ulcers I have read about.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
I'm sorry you're having such trouble accepting the truth. All that additional information makes no difference in my opinions or advice so far. The only thing I can add is that you consider professional counseling. to figure out why you are so psychologicallly resistant to the scentific evidence and to the reassurance you have received. Also do yourself the favor of going back and re-reading my replies above, concentrating carefully. The answers to these additional questions are there and I have nothing more to say.

That completes the two follow-up comments and replies included with each original question, and so ends this thread. Best wishes to you.
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