[Question #9448] Cunnilingus exposure-some professional reassure welcome
32 months ago
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Dr. Dr(s)
Over the course of a few months I’ve had a 3x encounters. All were with paid by appointment (non street or brothel) massage therapists/Sex workers. During our time I’ve engaged in oral on me, in addition to cunnilingus. I’ve always thought as this type of encounter to be safe, which is why, I rarely engage in full sex and when it has been, it’s ALWAYS with condom. 5 weeks post incident (33 days) I came down with a fever ranging from 100-102 that has lasted about 5 days. I’ve been able to keep it at bay with Advil and Tylenol. My fever was accompanied with the usual body aches. No sore throat, no rash that I can identify as ARS related. I’ve had a couple hives that have popped up and gone away in an hr or so, but attribute that to laying on my back all day, which is were I spotted them. Again, they are not there now and understand, ARS rash doesn’t come and go. A week or so prior to getting sick I had two separate canker sores in my mouth, both cleared up in about 2-5 days. I am usually pretty level about this stuff, but give these symptoms (that I shouldn’t read into) and my less than ideal oral Heath, I thought the timing was enough to at least post and ask the question, does this type of exposure warrant a test or let it go and move on knowing how often coincidences happen in life. PS - I’ve not proof read this and hope it has some sort of clarity.
Thanks
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Edward W. Hook M.D.
32 months ago
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Welcome to our Forum and thanks for your thoughtful questions. I'll be glad to comment. First your partners- few commercial sex workers have HIV, this is particularly true for higher cost, appointment only CSWs. In addition, your sense that cunnilingus and receipt of oral sex are low risk activities for acquisition of HIV are correct. There are no proven instances in which HIV has been acquired by receipt of unprotected oral sex and amongst exposures, cunnilingus, while VERY rarely associated with HIV acquisition is far, far less likely to lead to HIV than genital-genital or ano-genital exposures. Thus I am comfortable in saying that the risk for your symptoms to be due to the ARS are exceedingly low- approaching zero. On the other hand, COVID-19 which can cause the same symptoms and influenza are each far, far more common than HIV and can cause the same symptoms.
As for your approach, there are two choices- you can wait this out or you can seek testing. If you choose to seek testing, you should test not only for HIV, but also for influenza and COVID. A negative test at this time would rule out the possibility of HIV as the cause of your symptoms. Negative tests for COVID and flu would be similarly reassuring. Personally, I do not see a strong reason for testing at this time but that, of course, is up to you. I hope the information I have provided will be helpful to you. EWH
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32 months ago
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Thank you Dr for your kind and thoughtful reply. I just needed the reassurance that my exposure in addition to symptoms did not warrant a test. I see now noted from Dr HHH in other posts that 21 days is more on the higher end for ARS symptoms to begin and usually around 10-20 is more likely. That’s said, 5 weeks seems like a special case, as would cunnilingus. I’ve tested for Covid 3 times at home. Negative. I am in Canada, they do not test for the flu here unless you are admitted overnight in a hospital bed. On a side note, a few days before I got sick, my wife had major body aches and chills, felt a fever coming on that never materialized. Since then, she’s had a deep cough. My two kids are always coughing, but all good.No one but me landed a fever. Go figure. Thank you for your patience and expert guidance. Since I have one more reply, I’ll reach out should anything change. All good!
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Edward W. Hook M.D.
32 months ago
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I’m pleased that you found my comments helpful. You are certainly correct that for the ARS to begin five weeks following an encounter would be virtually unheard of. I’m pleased with your plans to move on. From the additional information you provide it sounds like some sort of flu like illness is being passed around in your family. I hope you all will be feeling better soon. Take care. EWH---