[Question #9479] Symptoms
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32 months ago
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Dear Doctor,
I am a 50 year old male from Belgium. Today exactly 3 weeks ago, I visited a female CSW. We had unprotected oral sex (2 way) and protected vaginal intercourse. But before intercourse she extensively rubbed her clitoris over my bare penis for several minutes. I did not consider these actions to be a risk for hiv and I think I read that this is also the expert opinion on this forum. So I was not even planning to do a hiv test after this event. But I have developed several strange symptoms and I do not longer know what to think.
Five days after the contact I developed a sore throat. Not a sore throat that seems cold related (no cough or nasal problems). In the following days (6-10 days) I got several other mild to moderate symptoms: swollen lymphnodes, headache, pain behind the eyes, bowel and liver inflammation and most explicitly, joint pain in elbows and knees and muscle pain. Some symptoms have gone away, but the sore throat and joint pain are still there. Although I have felt feverish, my temperature never got over 37.5C. I also did not develop a rash. I am just not feeling well without really being sick for 2.5 weeks now.
I am requesting your guidance/opinion.
Robert
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Edward W. Hook M.D.
32 months ago
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Welcome to our Forum. Thanks for your confidence in our service. I'll be glad to comment. You activities you describe were virtually no risk for acquisition of HIV. Even before we discuss specific sex acts, please remember that most CSWs do not have HIV. Even in the unlikely circumstance that your partner had HIV, there is no known risk for acquisition of HIV from receipt of receipt of oral sex or from your partner rubbing her clitoris/vagina over your penis in the absence of penetration. Similarly, as long as condoms were worn throughout the sex act and did not break, condom-protected sex is safe sex. There have been a handful of instances in which HIV has been acquired from an untreated, HIV-infected partner but it is vanishingly rare (the CDC estimates the risk of cunnilingus on an untreated, infected partner as less than 1 infection, on average, per 10,0000 sex acts (i.e. 99.99% do NOT result in infection) and personally I suspect that estimate is overly conservative. Thus, your risk from the encounter you describe was close to zero.
In terms of your symptoms- they are non-specific. COVID-19, influenza, and any number of less well characterized, non-STI community acquired viral infections are far more likely to be causing your symptoms than recently acquired HIV. Further, the symptoms you describe do not suggest the ARS as high fever is an important part of the syndrome.
Personally, my advice is not to worry but, if it would make you feel better, if you test with an 4th generation, combination HIV antigen/antibody test and it is negative, that will prove that your symptoms are NOT due to HIV. When persons are experiencing symptoms for recently acquired HIV, their HIV tests are always positive.
I hope this perspective is helpful. EWH
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32 months ago
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Thank you for your explanation.
My joint and muscle pain still worry me a little bit, as I never experienced this before. So I might do a test in the coming weeks just to feel better. But I fully understand my risk was actually (almost) zero.
Robert
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Edward W. Hook M.D.
32 months ago
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I'm pleased the information I provided has been helpful. Take care. Please don't worry. EWH---