I had protected intercourse using a non-latex condom with a woman of unknown HIV status.  We performed unprotected oral sex on each other. We are both 40 years old.  The woman was very aroused and her vaginal fluids were flowing.  A couple weeks later I noticed some scratch marks in between my scrotum and my inner thigh, where my leg meets the groin or pelvis area.  There's a natural crease in the skin there and in that area is where the scratch marks are.  They are healing but I can tell they did bleed before.

I got the scratch, I believe, from putting my finger in between my scrotum and inner thigh to scratch an itch and apparently I cut myself while doing so.  I wasn't sure if I had the cuts during sex or not.  I assume I did.  To see this area I have to spread my leg or move my scrotum to see it.  To scratch it I can squeeze a finger in there while standing.  Hope that makes sense. 

As far as her history she had unprotected sex with a man from the navy one year ago and no sex since until I came along.  She assured me he was clean because navy members go through vigorous testing and vaccines.  She said if one has HIV they can't be in the navy. IDK if that's true or not.  She hasn't been tested. We both have HSV-2.

1) I'm not sure if my sores in between my scrotum and inner thigh were there during intercourse.  If they were and open, would that be a risk for HIV?  Please explain why and that helps me understand the answer.

You really needn't be worried about HIV. The chance a partner like yours has HIV is extremely low, probably under one chance in several thousand. And her comments about low risk from sexual exposure with US military personnel are accurate; there is little chance she has ever been exposed to HIV. And even if she had, exposure of a superficial cut to infected body fluids is extremely low risk for infeciton. I really do not believe you were at any risk at all of HIV in this situation. That's especially the case for a skin defect you can hardly see!

All things considered, this was a zero risk event in relation to HIV. I recommend no testing and no worry!

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

HHH, MD

1) is a red face/rash  common with seroconversion if it were HIV? 

1A) is 21 days too soon for seroconversion if it were that?

2) are vaginal fluids less risky in transmission than blood? 

3) and performing cunnilingus is a low risk HIV activity?

1A) Antibody detection (seroconversion) can start around 10 days, but usually takes 2-4 weeks. 21 days is about average.

2) In HIV infected persons, vaginal fluids and blood contain about the same amount of virus and therefore exposure is similarly risky for either one.

3)There has never been a reported case of proved HIV transmission by cunnilingus (to either the vaginal or oral partner). That doesn't mean the risk is zero, but it is extremely low.

Since my advice obviously hasn't eliminated your fears, as I hoped it would, you should be tested. A negative AgAb (4th generation) blood test a week from now would be nearly conclusive (98-99%). This doesn't mean I believe there is any chance you have HIV -- only that I hope you will be more convinced by a negative test since my expert opinion hasn't helped. But really, this is a giant nothingburger!

A) I did do an: 

 ag/ab 4th generation HIV test via a lab today, which is day 25 from the incident. How conclusive would that be percentage wise?

B) Are swollen lymph nodes in neck a sign of seroconversion? 

C) And lastly based on your experience are women and military positive HIV cases rare in the US? 

Your detailed responses really help. Not only do you answer but you explain why. Thank you again. 

B) Acute HIV commonly causes lymph node enlargement in the neck and elsewhere. However, it is impossible to have HIV symptoms with a negative blood test. So although your negative AgAb test doesn't prove you did not acquire HIV, it IS 100% proof that this or any other symptoms you may have are not caused by HIV.

C) HIV is very rare among US military personnel and their partners, but I cannot quote specific data. When military personnel are infected, usually it is from the same risk factors as for anyone else (mostly men having sex with men, injection drug use, and the like). Probably a few infections result from high risk heterosexual exposures, perhaps especially during overseas deployments.

Thanks for the thanks -- I'm glad to have helped! That concludes this thread. Have a final AgAb test 6 weeks after the exposure you are concerned about. If your partner is associated with the US military, you can safely assume s/he doesn't have HIV and you can expect the result to remain negative. Best wishes and stay safe (as you have been!).