[Question #8553] Oral msm please advice

42 months ago

Dear drs i will not waste your time i live in gulf i met a male we do oral unprotected sex mutual 69 for seconds no ejaculation in mouth we have deep kiss and no penetration at all we have sone fingering and we ejaculate on floor and left .. 13 days later i have neck shoulder muscle pain and headache in my back head .. no fever no sore throat no rash usually i have herpes in my lips but its not active while exposure

1 did i should worry to contact hiv ?

2 what percentage to catch hiv regarding this in your opinion ?

3didi if i have covid or past herpes increasing the risk to catch hiv

3 its my 1st time to do this usually i do sex only with my wife i your opinion do i need to test or not and move on

4 can i make unprotected sex with my wife or its risky

Do u think this sysptoms related to hiv early infection

And last please and i know you will do it but please Give me your advice based on your personal convictions and experience in the field and never take into account my concerns as you best expert

Thanks

H. Hunter Handsfield, MD

42 months ago

Welcome to the forum. Thank you for your confidence in our services.

My first comment is to congratulate you for having only safe sex with this partner.

1,2) Oral sex is very low risk for HIV. There has never been a proved transmission of the virus mouth to penis, and only rare cases penis to oral. One estimate (by the US Centers for Disease Control and Prevention) is 1 chance in 10,000 for the oral partner, if the penile partner has HIV; and 1 in 20,000 in the other direction. These estimates suggest that it would take daily exposures of this type for 27 years or 55 years, respectively, before transmission might be likely. Kissing is similarly very low risk, with few if any known transmission events.

However, the risk of other STIs is somewhat higher. Gonorrhea, nongonococcal urethritis (NGU), and herpes are possible. However, if you have no symptoms (penile sores, penile discharge) in the next 7-10 days, you can be very confident you did not catch any of these.

3a) COVID-19 is not known to have any effect on HIV risk. Genital herpes due to HSV2 roughly doubles the risk of HIV for genital or anal sex, but not oral. Oral herpes and HSV1 have no effect on HIV risk.

3b) I would not recommend HIV testing on account of this event. However, this is up to you and your partner: if you both get tested now, you would both know neither of you was at risk. If only you are tested, you could have an antigen-antibody (AgAb, "combo", "4th generation") blood test in a few weeks. However, if I were in your circumstances, I would not be tested at all.

4) Here too I cannot tell you what to do. If it were me, I would continue unprotected sex with my wife without worry about HIV.

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

HHH, MD

---

42 months ago

Thanks dr for your time and kind reply that changed my mind and erase my fears thanks alot .. but last question i mention some symptoms but unfortunately you didnt comment on ot .. i n my 13 days later i have neck muscle pain with shoulder and headache in my back head .. i think the headache because of the neck muscles pain the next day its almost gone then after a day stomach pain i dont know if its muscles of my tommy or colon maybe from my stress and do small excerise as well .. in your opinion this syptoms are related to any infection or early hiv infection common symptoms and whats the exact muscle aches pain in early infection of hiv .. please your last advice and thanks so much

H. Hunter Handsfield, MD

42 months ago

Sorry -- I meant to comment on your symptoms.

They do not suggest HIV or any other STI. The timing is wrong -- and although muscle aching can occur with HIV, you're missing all of the most common symptoms of a new HIV infection (fever, sore throat, skin rash, enlarged/inflamed lymph nodes). All symptoms of HIV are nonspecific, meaning they do not point to HIV any more than to other minor medical conditions. This really isn't anything to be worried about.

---

42 months ago

Thanks for your reply doctor but what do you mean by timing is wrong .. you mean 13 days after exposure is too late and its not a suggest to any sti infection and noting to worry regarding this thanks

H. Hunter Handsfield, MD

42 months ago

Yes, 13 days is later onset than normal for HIV symptoms; and as already discussed, they are not typical HIV symptoms anyway. As for other STDs, they never cause symptoms like you describe. These symptoms have nothing to do with the sexual exposure you are concerned about.---

42 months ago

Doctor I'm sorry i start today diahrea and some dry cough ... This is my last question im sorry .. do you still confident that the situation is the same and nothing to be worry for my risk .. ipromise that its my last asking for this .. good day for you

H. Hunter Handsfield, MD

42 months ago

Yes, I remain confident this is not due to HIV: too late, and acute HIV doesn't cause cought. However, these symptoms are very typical for the start of COVID-19. Get tested ASAP. Good luck.

That concludes the two follow-up exchanges included with each initial question and so ends this thread. (Three, actually -- but the first was my fault for initially forgetting to comment on your earlier symptoms.)

---