Very worry about HIV exposure

[Patrick1984]

Dear Drs Hooks and Handsfield,

    It's been 8 weeks since my possible HIV exposure and I have been living in a fear for at least 5 weeks, my life is suffering and hopeless, so I really really need your help! I had a trip to Shanghai, China last month and in there I had an unprotected oral sex with a street worker, she gave me a blow job and I had ejaculation in her mouth (I think the total time my penis in her mouth was less than 2 minutes) but I think she split it (my semen) out right after I did that. Her HIV status was unknown. Then the next day I had a protected vaginal sex with a street worker (she requested to use condom otherwise she wouldn't do it, but her HIV status was unknown also) and I had ejaculation inside her (inside condom actually), but couldn't recall if the condom was broken but I remembered she removed the condom after I pulled out from her and she wiped out the semen on my penis by tissue, I asked her if my semen leaked insider her vaginal (I tried to make sure if the condom was not broken) and she said no. The total time was about 5 minutes. That's all the sexual deals I had, but after those sexual deals I began to have some symptoms such as: Sore Throat (gone in 2 weeks), Body ache (most on my arms, shoulders and back), Swollen lymph gland (I am not really sure about this but whenever I touch my neck, I can feel there is a small bump on the neck and a little bit hurt when touch, also include swallowing but gone in 4 days), Diarrhea (on week 7 after those sexual deals, but only last for 3 days), Skin rash (on week 7 after those sexual deals, small red dots are flat appear on my chest, shoulders and back, not itchy and not a lot actually). But I never have fever and headache at all.
    Now my questions are: what is the risk or chance that I could be infected by HIV and do I need to do a HIV test? I am very scared now and my life is totally ruined, so your help is really matter to me! Please help me! Much appreciate!



Best
Patrick

[Edward W Hook, MD]

Welcome to the Forum.  The exposures you describe did not put you at risk for HIV.  No one has ever been shown to acquire HIV from receipt of oral sex and condom protected sex is safe sex. Thus, even if your partner had HIV, there was no risk for infection from the activities that you describe.  

The symptoms you describe are some of those which are seen in persons who have recently acquired HIV however these are common symptoms with many causes. When persons have typical symptoms such as yours, less than 1% turn out to have HIV.  Given the nature of your exposure, I would not worry.

To address your concerns, I would suggest that you have an HIV test using a 4th generation test for HIV.  I suggest this not because I think you have HIV but because I think the assurance of a negative test at this time will help your anxiety.  If you had acquired HIV at the time you mention, your test would be positive at this time

I hope these comments are helpful to you. EWH

[Patrick1984]

A related discussion, HIV antibody test after 5 months is conclusive? was started.

[Edward W Hook, MD]

The rash that you describe in no way suggests HIV.

As for testing, to worry about testing is silly.  Testing will not change the result, it will only provide the power that comes with knowledge.  In your case, the test will be negative, proving that your symptoms are not due to HIV and you can move forward with your life.  EWH

[Patrick1984]

Dear Dr. Hook,

    Thank you so much once again to reply me, right now most of the symptoms are gone except the skin rash, it is some flatted red dots that on my chest and non itchy, today I checked again and found out they have more on my chest now, I am very worry as are these red dots are caused by the HIV infection? I am thinking about the HIV test but just scare to know the result if it is not what I expect, just don't know what should I do. Usually the skin rash will last how long? I can't sleep well and anxiety all day long, just don't know what should I do, so please give me some help. Thank you and much appreciate for you help!

Best
Patrick

[Edward W Hook, MD]

1. If during the oral sex my partner has cut, sores or abrasions in her mouth and and say she is infected HIV am I will be in the high risk to get HIV infection?

Still no risk for HIV.

     2. If during the protected vaginal sex the condom is broken am I also will be in the high risk to get HIV?

If the partner is infected the risk is 1 in 1000 (0.1%)

     3. As you said I should take the HIV test but still I am really scared about the test, in this case what should I do? Still force myself to take the test?

Taking the test will not change the result and I anticipate the test will be negative.  EWH

[Patrick1984]

Dear Dr. Hook,

    Thank you so much for your reply and that's really helps a lot! I have few more questions want to ask and hope you can also answer them for me:
    1. If during the oral sex my partner has cut, sores or abrasions in her mouth and and say she is infected HIV am I will be in the high risk to get HIV infection?
    2. If during the protected vaginal sex the condom is broken am I also will be in the high risk to get HIV?
    3. As you said I should take the HIV test but still I am really scared about the test, in this case what should I do? Still force myself to take the test?
    Thank you very much for your help and replies me so quick, I am really appreciate it!

Best
Patrick