[Question #7660] Hiv risk & symptoms? Please help

1 months ago
Hello Doctor i need some help. Last month ( January the 18th) i visited a colombian female escort here in Ireland. I performed 20 seconds of cunnilingus on her, i haven't been to the dentist in quite sometime & i have receding gums one of which has been inflamed for sometime & occasionally bleeds when brushing but not much. Anyway i brushed my teeth maybe an hr - 45 mins prior to this brief cunnilingus episode & never seen any visible bleeding just the usual inflamed gum. Anyway a few days after i started getting a sore throat that lasted a week & a half then went away. Then a few days later i noticed weakness in my legs, tiredness, glands in my neck up, a couple of mouth ulcers, shivering, but what really concerns me is ive had diarrhea for 12 days non stop! & lost weight. This has got me very concerned about the risk of hiv I've got nearly every early symptom except the rash. Im petrified to be honest i did std screening 3 days ago & im waiting on the phone call for results. Im very worried. Has anyone ever caught hiv this way or is all this a coincidence & i have maybe something else? Thanks for listening Dr
Ross
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Welcome to the forum. Thanks for your question.

I really don't think you need to be worried. Your closing line is on the mark:  I'm quite confident your symptoms indeed are just a coincidence, not related to last month's sexual experience. Here's why:

Cunnilingus is low risk for HIV and all STDs. There has never been a proved case of HIV transmission, to either the oral or vaginal partner. Oral sores, gum disease, etc in theory could raise the risk a little bit. However, there must have been millions of oral sex exposures in the presence of such conditions, and still no known cases of HIV transmission. Other STDs also are low risk. For example, in heterosexual men with gonorrhea, oral infection is present in under 2%, even among those who performed oral sex on the partner from whom they caught gonorrhea.

As for your symptoms, they are not typical for a new HIV infection (called ARS, for acute retroviral syndrome). ARS symptoms can include diarrhea, but rarely as such a prominent symptom. That said, I can't say with 100% certainty you don't have ARS, but I will be very suprised if your test a few days ago turns up positive. It isn't possible to have ARS symptoms for nearly 2 weeks and have a negative HIV antibody test -- so a negative HIV test result will prove your symptoms are not due to ARS. 

Let me know if anything above isn't clear. And I look forward to hearing your test results when you have them. Try to stay mellow in the meantime:  the odds are strongly in your favor -- you're not likely to be the world's first clear case of acquring HIV by such contact.

HHH, MD
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1 months ago
Thank you for your reply Doctor. I have woken up today & I am even more freaked out because a number of small individual pimples have come up seemingly over night! There must be about 5 or six on my back 3 or 4 on my tummy/chest & a couple on each of my arms. They are like pimples/spots & are sore if you touch them they are well spaced out from each other , im trying my best to stay calm & wait on the results but seeing this today after ive woken up is worrying me to death. I would of thought myself 20 seconds of cunnilingus is nothing but i cant understand why i have these symptoms. In the past i did catch lyme disease from a tick bite & took quite alot of antibiotics to fix that, im worried that with maybe my immune system not being the strongest due to the lyme & my not so great gums this combination has maybe created a gate way to contact hiv. The escort lady said she was ' clean' before i did the cunnilingus, I've seen her a number of times in the past over maybe 3 or 4 yrs & seen she lost 3 stone in weight, another time a few yrs ago she said she was getting tired but didn't know why i told her to go to the hospital she said she did but they couldn't find anything wrong with her. However on that last day i seen her (just after the cunnilingus) she was saying she had iron deficiency & had to go the next day to get iron tables from a doctor. I am petrified of the results coming & im so sad I've kind of resigned myself to thinking i have caught hiv of this seemingly very small risk encounter. We did protected sex my penis to her vagina but the condom looked perfect to me, no problem there. The only other thing i can think of that maybe doing all this is maybe i have liver problems as i occasionally get sharp pain in my liver ( im 33 yrs but drank maybe abit to heavy over the years) one time i went to my dr yrs ago & my liver was indeed inflamed & i haven't been back to get that checked since. But as far as sex goes ive never once in my life did unprotected vaginal sex with any woman. Sorry for for rambling on abit thank you for your reply & i will let know my results next week Best regards Ross
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Thanks for the additional information, but it doesn't change my opinions or advice. Increased acne or new pimples are not known to occur in association with a new HIV infection.---
1 months ago
Hi Doctor, just an update i got my results back today & all were negative, but they said to come back at the 12 week mark to run some tests again for hiv, syphilis & somthing else. Today i have noticed my tongue very sore & when i looked at it in the mirror theres an area with a bunch of pinkish white dots they are sore & make it difficult to talk also i can't move them with  my finger nails like the way i could brush the oral thrush/candida away, they are like little blisters. i was was looking online & it seems like hpv could it be? I must of got it of that very brief cunnilingus episode coz ive never had this before what stds could have possibly been transmitted from her vagina to my mouth? If it is hpv what can i do about it? I know this is another question & I'll happily pay for another question i just really want to get to the bottom of whats going on with me since that cunnilingus episode. I want to say i really appreciate you're time & expertise & I'm very grateful for helping an idiot like me out lol. Can i forward you a picture of my tongue for you to take a look at? 
Many thanks Ross 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
1 months ago
Even though some doctors and clinics advise testing for HIV and/or syphilis at 12 weeks, it isn't necessary. Assuming you had an AgAb ("duo", 4th generation) blood test, the result is conclusive any time 6 weeks or more after the last possible exposure. You're home free and needn't worry further about HIV. Presumably your testing already included a syphilis blood test. That too is conclusive at 6 weeks, although there's a little bit more uncertainty than for HIV, and some experts indeed recommend a final test at 3 months. However, based on the exposure you have described, the chanse you have syphilis is exceedingly low.

Indeed you could have acquired an oral yeast infection (thrush) by performing cunnilingus, if your partner had a vaginal yeast infection. However, no standard STD causes this; you know you don't have HIV; and HPV never causes any symptoms like this. Oral HPV isn't rare, but it's uncommon -- and occurs frequently in persons who have never performed oral sex. The chance of oral HPV after a single exposure is very low. Anyway, if you have it, there is little chance it will ever cause symptoms or any health problem, and it will not be easily transmitted to future sex partners. So it really shouldn't be a worry for you.

Unfortunatley, we do not accept or view posted photos of users' rashes, lesions, oral problems, er anything else. It comes too close to practicing medicine from a distnace, which we cannot do. If you remain concerned, see a doctor in person -- or your dentist.

That completes the two follow-up exchanges included with each original question and so ends this thread. You can move on without further worry; you probably have no infection of any kind from the exposure descirbed, except maybe an oral yeast infection -- which is a minor inconvenience, not an important health problem. Thanks for the thanks and kind words; I'm glad the discussion has been helpful. 
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