[Question #7988] Risk assessment for oral exposure
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50 months ago
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Hello so my exposure was performing oral on a straight male. He says he got tested 7 months ago and uses condoms all the time but obviously people can lie. I gave him oral June 8th, he ejaculated on my chest not in my mouth.
June 14th (six days later) I felt the beginning of a sore throat oncoming. It got worse until it peaked June 16th and 17th (8 and 9 days after exposure) and is now getting better today (10th day after exposure)but still hurts to swallow. From what I can tell sore throat is the only symptom I’m experiencing. The highest my temperature got was 99.1. So not exactly a fever. I also got vaccinated for covid a little over a month ago so I don’t think it’s that.
My question would be, what is my risk for HIV from this exposure and considering my symptom? When would be the earliest I could test for conclusive results? Would you even recommend testing after this exposure? Thank you.
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Edward W. Hook M.D.
50 months ago
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Welcome back to the forum. I’ll be glad to come at. The exposure you described was low risk. Most heterosexual men do not have HIV (HIV infection rates in heterosexual men are a small fraction of 1%) and the risk of acquiring HIV from performing fellatio on an untreated HIV infected man is less than one infection for 20,000 sex acts. He states that he was tested and use condoms and while some people do not tell the truth, most people are truthful and such statements.
Your sore throat occurred earlier than the sore throat associated with recently acquired HIV. Further, when persons with recently acquired HIV get sore throat, the sore throats are accompanied by high fevers (>101 degrees) and severe muscle and/or joint aches. Most typically the symptoms occur between two and three weeks following exposure so the onset of your sore throat there’s also a bit early to be due to HIV.
Your risk for HIV from the exposure you described is very, very low. If your symptoms were due to HIV, a fourth generation, combination HIV antigen/antibody test would be positive at this time. Symptomatic HIV is always associated with positive tests. If you choose to seek testing, I am confident that it will be negative.
I hope the information I have provided is useful. As you know, we provide up to three responses for each clients questions. If you have further questions or need clarification please feel free to use your follow ups. EWH
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50 months ago
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Thank you I will be going to test today then to see if my symptoms are ars associated.
When would you recommend to test to be entirely conclusive? Even if I test negative today I want to be sure I test conclusively from this exposure. Would two week rna be sufficient or would it be better to wait 6 weeks for 4th generation?
Is oral more of a theoretical risk or do people typically do get infected this way? I usually don’t mind oral because it used to be seen as safe in regards to HIV but it seems that now it’s regarded as higher risk?
Also
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Edward W. Hook M.D.
50 months ago
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As you point out, some persons can acquire HIV without developing symptoms. Combination HIV antigen/antibody (4th generation) tests which are the tests routinely performed are entirely, 100% conclusive six weeks following an exposure.
I am confident that your tests from today and in the future related to this encounter will be negative. EWH
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50 months ago
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Thank you but what about my last questions,
“ Is oral more of a theoretical risk or do people typically do get infected this way? I usually don’t mind oral because it used to be seen as safe in regards to HIV but it seems that now it’s regarded as higher risk? ”
Also considering my symptoms do you personally recommend testing for this encounter? Or after oral exposures in general?
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Edward W. Hook M.D.
50 months ago
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I believe I answered your question in my earlier reply. A very, very few people do acquire HIV through performing oral sex on untreated, HIV infected persons. The estimated risk of infection, as I said before, is one infection for 20,000 sex acts. In your specific case because it is so unlikely that your partner even had HIV, your risk of infection is certainly less than one and 100,000 and perhaps less than one in 1 million. That is not zero although it means there is a 99.999% likelihood that you were NOT infected. Personally I believe the risk is so low that I would not necessarily seek testing if I were in your situation however, testing is a personal decision and that is up to you.
I am confident that your symptoms are not associated with HIV acquired during the exposure you’ve described..
As you know, this is my third response to your questions. Therefore, this thread will be closed shortly. I hope the information I have provided has been helpful. Please don’t worry. EWH
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