[Question #7869] Hiv worry

51 months ago

Hi doctor ,

I am a gay male.

I recently had an exposure with a male of Unkoen status . We only kissed . Nothing else happened . I think I tasted some blood and he had braces .

I came across your forum on medhelp as well where you say kissing isn’t risky .

However I have noticed on this website that you said that there may be a risk or Low risk with kissing .

Also to mention I had a fever of 99 to 99.2 degrees for about 2 days.

I had a lot of indigestion , lack of appetite and a slight pharyngitis .

Am I at risk ?

I haven’t had anal sex and no other exposures in the last 1.5 years .

Request your valuable advise. Thanks again for the wonderful work you are doing on this forum .:)

Edward W. Hook M.D.

51 months ago

Welcome to our forum and thanks for your questions as well as your confidence in our service. I’ll be glad to comment. I am not sure where you saw a statement by either Dr. Handsfield or me that kissing is a risk factor for acquisition of HIV. While I suppose that is theoretically a possibility, just like it is theoretically possible that you will be struck by lightning while reading my reply, in truth the risk of kissing is virtually zero. There is no known risk for acquisition of HIV from kissing, even when one of the partners has oral bleeding, come disease, or a sore in their mouth. It is far more likely that you acquired in every day, community acquired viral pharyngeal infection. I would not worry about HIV in the situation you described and see no reason for testing.

I hope this is helpful to you. If anything is unclear or there are further questions, please feel free to use your up to to follow up questions for clarification. EWH

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51 months ago

Thanks dr hook ,

This is a relief .

I can’t exactly recollect where i read the post on kissing . It was on this forum and I guess the word used was low risk .

The slight fever I had after 3 weeks of the kissing got me a bit worried . We’re my symtoms consistent with the ars ?

Could ars cause a low fever for 3 days ?

Also are you aware of any cases of hiv spread through kissing in presence of bleeding gums , etc .

Thanks again .

Edward W. Hook M.D.

51 months ago

I think that you were worrying too much. As I said, I am not aware of any proven cases in which HIV has been transmitted through kissing. Further the presence of a sore throat and a low grade temperature are not suggestive of the ARS. The ARS typically includes high fever, severe sore throat, and severe muscle or joint aches. As I said earlier your symptoms are more consistent with an every day community acquired viral pharyngitis. EWH---

51 months ago

Dear dr

Thanks for your response .

Just wanted to check a few more things :

1. I have been getting pimples , boils and acne more often than before . I also had folliculitis near my armpit area (as diagnosed by the dermatologist )

Could this be related to hiv or any std ? I read that hiv causes skin issues and folliculiyis .

2. My last hiv test was 6 months back . I haven’t had sex or any in the last one and a half years (except kissing twice). If my exposures are limited to kissing and mutual masturavtion, is hiv testing still needed regularly ?

3. I have NOT had anal sex ever because I am very scared of contracting an std or hiv .

How effective are condoms for anal sex ? Also would you advise starting Prep ? In case I plan to be sexually active would prep be effective in protecting me from hiv ?

4. Lastly are there any side effects of prep? How long can I take Prep for ? What is the effectiveness of prep plus using condoms as far as hiv is concerned ?

5. Finally just wanted to understand , as you said kissing is not a risk even if presence of blood . However I sometimes do have bleeding gums when I brush in the mornings . However I kissed this perosn in the evening and as I mentioned he had braces and i tasted blood I guess .

This would still NOT pose a risk for hiv right ?

6. Finally can ars symtoms last for just 2 to 3 days ? Or are they usually much longer . ? Mine was a fever of about 99 to 99.2 on and off for 2 days .

This happened 3 weeks after the exposure .

Thank you dr hook for all your help and valuable advice .

Edward W. Hook M.D.

51 months ago

Thanks for your follow-up questions. My sense is that you have been reading about the manifestations of HIV infection on the Internet. I will caution you that much of what is found on the Internet is taken out of context or sometimes just plain wrong. Let’s address your questions and I think you’ll see what I mean:

1. There is a relatively uncommon form of extensive folliculitis which may occur in persons with untreated HIV. In the vast the journey of persons with folliculitis however the issue is not HIV. Your negative test indicates that this is likely not the issue for you.

2. There is no risk of acquisition of HIV from kissing including open mouth kissing or kissing persons who have tooth or gum disease. If you were only exposure is kissing I see no reason for periodic testing.

3. Anal sex sex can be participated in safely. While receptive anal intercourse is the sexual activity with the highest risk for acquisition of HIV if your partner is untreated and infected, condoms are highly effective for HIV and STI prevention. Condom breakage rates are slightly higher with anal intercourse than other forms of sexual exposure however this slight increase in risk may be reduced by use of lubricants. Decisions regarding PeEP are complex. Prep is highly effective for prevention of HIV and is recommended for persons who regularly put themselves at risk but does not prevent acquisition of other STIs. We encourage use of PrEP for at risk persons but it is, of course, a personal decision.

4. PrEP, Like any medication, may have side effects however in general it is well tolerated and side effects are rather uncommon. Persons can take PrEP for long periods of time. In terms of HIV prevention the additive affect of condom use is relatively modest however, as noted above they certainly do substantially reduce the risk for acquisition of other STIs.

5. Correct, kissing even in the presence of mouth sores or oral bleeding is not a risk for acquisition of HIV.

6. The symptoms of the ARS are typically relatively severe and last more than two or three days.

I hope the information I have provided has been useful to you. As you know we provide up to three responses to each client questions. This is the third response to your questions and there’s this thread will be closed shortly without further comment. Take care. Stay safe. EWH

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