[Question #9103] HIV worried

36 months ago

Hello doctors.

Since my last negative test for HIV, I have had two encounters:

1: 9 weeks ago, oral sex with condom and vaginal sex with condom, with a sex worker, it was fully protected by condom which remained on the entire time and did not break.

2: 4 weeks ago, naked body to body massage with a masseuse, the masseuse's vaginal fluids were able to come in contact with the skin on my back and buttocks. As I said in my previous question several months ago, I have psoriasis on the skin of my buttocks, although it is mild, no sores and never bleeds. In this last encounter there was no penetration at all.

My concern is because since a week ago I have had some redness on my face and forehead with some pimples, and also on my shoulders. No fever or sore throat or any other symptoms.

I am concerned that this has to do with a possible HIV infection.

Do you recommend testing and stopping my sexual relations with my wife?

Thank you very much in advance. Best regards.

H. Hunter Handsfield, MD

36 months ago

Welcome back, but this will have to be your last question. You are seriously over-worried about obviously low risk sexual exposures. These kinds of exposures have been discussed with you several times on the forum, and you either do not believe or for some reason cannot accept the reasoned, science-based advise we have given. You already have seen our advice about the low risk of oral sex, that condoms work, that body contact without penetration is no risk, and that test results overrule both exposure history and symptoms. If there is no unprotected penile penetration into a partner's vagina or rectum, there is no risk for HIV!

Neither HIV nor any other STI causes pimples or redness on the face and shoulders, and you have not been at risk. You do not need testing for HIV or anything else, and you need not stop having sex with your wife. Of course you are free to be tested for HIV if you wish, but there is no chance you have it.

You have been advised previously about the forum policy on repeated anxiety driven questions. In the future, we will have to follow the policy for similar exposures or other questions that have already been answered in earlier threads, i.e. deleting the question without reply and without refund of the posting fee.

I do hope this final reply is helpful. Thank you for your understanding.

HHH, MD

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36 months ago

I am very sorry for your anger, it was simply my understanding that a papular macular rash like the one I have on my face, forehead and anterior shoulders is one of the symptoms of ARS and that is what scared me and what differentiates this question from the previous ones.

Otherwise I would not have insisted on the subject.

Sorry.

H. Hunter Handsfield, MD

36 months ago

You owe no apology -- but I do. I'm sorry for the assertive tone. It's not anger at anxious posters, but frustration when previous advice seems to have had no effect. Of course we know how new symptoms can be alarming. But really, try to remember when symptoms occur that exposure history is FAR more reliable in predicting the chance of HIV than symptoms are. There simply are no symptoms that override a low risk exposure: no matter now seemingly typical for HIV, if the exposure was zero risk, something other than HIV is the cause. (And skin rash alone never would be the only symptom of a new HIV infection.) In the 15 years of our online forums, there has never been an exception. (In those 15 years, with thousands of questions from persons worried about HIV, not one became infected. If and when that finally happens, it will be from a genuinely high risk exposure -- like unprotected anal with a known infected partner -- and not an event that has never previously resulted in HIV infection.)

Anyway, you needn't worry about HIV in the current circumstance. But do try to limit future questions to ones that don't re-open the same sorts of questions you have asked previously. OK?

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36 months ago

Ok, an thank you for your kind reply.