HIV Exposure

Hello DR. on March 8th I had protected vaginal sex with a friend of mine. Before we had sex I asked her the last time she had a HIV test she said the Sunday before (it was a blood test but she got the results in mins),So that would have been on March 8th she took the HIV test. I also asked her the last time she had sex she said almost a month and a half ago. Even though we had protective sex the condom was not rolled all the way down to the base. So about a inch of my skin was exposed. She was not on her period but there seemed to be a little blood a very little. I’am assuming because she had not had sex in a month or so. I do remember this happen once before with her. Like I said it was a little blood, but some was on the condom and I’am scared some may have touch my penis. I’m also scared that even though she got tested what if she got tested during the window period of the her last sexual encounter a month ago. And last I seemed to have four little rash marks on my body. I was looking online and I came across Pityriasis Rosea, and I believe what is called the herald patch is on my ankle its large and oval and its been there for a week or two. Then I have some small  ones. One is on my shoulder blade another one ryte beneath my armpit and two other ones on the side of my rib cage. Its spring time and I do have allergies so I know my body goes through some changes. i also got tested today for hiv with a mouth swab and it was negative. one last thing after we had sex i checked the condom and it was still intact.

Questions
1. Could I have caught HIV in this Situation
2. If the rash is not Pityriasis Rosea and its related to HIV no matter how soon I took the HIV test wouldn’t   it show up when symptoms do?
3. Could I continue unprotected sex with my girlfriend?

[H. Hunter Handsfield, M.D.]

Welcome to the forum and thanks for your question.

You describe a low risk situation, i.e. a "friend" (with whom you apparently are moving toward a committed relationship), and a partner proved not ot have HIV, by two separate tests a month apart.   The statistical chance she has HIV but was tested in the window period is astronomically low -- aero for practical purposes.  And you have had condom protected sex on top of all that!  Blood exposure during sex, with a condom, doesn't elevate risk either.  And on top of all this, you have even had a negative HIV test yourself.  To be honest, I have a bit of difficulty understanding why HIV is even on  your mind.  To your specific questions:

1) No, you could not have caught HIV.  See above.

2) Rash is never the only symptom of ARS; there has to be fever, sore throat, and usually other symptoms as well.  But I won't comment on other causes of the rash; self diagnosis by online searching by a non-health professional is very unreliable.  Whether you have pityriasis or something else isn't something I can judge and neither should you.  My advice is to see a doctor or clinic about it.

3) From an HIV standpoint, I see no reason you and your partner cannot safely have unprotected intercourse, or any other sexual practice that you both enjoy.  However, the relationship still is new and you don't mention ohter STDs.  My advice is that both of you see your respective primary care doctors/clinics to be tested for common STDs.  (FYI, the rash of secondary syphilis can look a lot like PR -- although syphilis is even rarer than heterosexually transmitted HIV.)  Even better, you could both go together to your local healath department STD clinic or a Planned Parenthood clinic.

I hope this has been helpful.  Let's not get into any "yes but" or "what if" questions.  There is nothing you can add that would change my opinion or advice.  Feel free to report the outcome after you (and preferably your partner) have been professionally evaluated, but I won't have anything more to say until then.

Best wishes--  HHH, MD

[H. Hunter Handsfield, M.D.]

I may have misunderstood about your partner having 2 HIV tests.   But it doesn't change my opinion or advice.

[alilworried721]

I'am sorry for my wording. She had one HIV test  3 to 4 days before me and her had a sexual encounter and she took that test on march 8th. I do have a girlfriend who is not the girl i had sex with in the situation iam describing above. I did take a HIV mouth swab test today that came out negative. Me and the girl i described above had protective sex but i do have unprotected sex with my girlfriend. Judging on the situation is it ok for me to continue to have unprotected sex with my girl friend. I have anxiety about HIV thats why iam asking, and guilt may play a role in this since i cheated on my girlfriend.

[H. Hunter Handsfield, M.D.]

Ah -- I didn't understand you were speaking of two separate partners.  Sorry.

But it really doesn't change anything.  The risk of heterosexually transmitted HIV is low for any single exposure, even with an infected partner and even without condoms; and you used a condom; and your casual partner had a negative HIV test.  So I continue to consider it safe, from an HIV standpoint, for you to continue unprotected sex with your regular partner.  And I ssee no need for STD testing either, since you (and your partner, I assume) have not recently had unprotected sex with other people.

[alilworried721]

just to make sure you understand what i was saying...i did use a condom the whole time and the tip of my penis was coverd and the only part that  was exposed was at the base of my penis because the condom was not rolled all the way down. But only about a inch was exposed and all the skin was intact. I apologize if the question seems to be repetitive i just want to make sure i'am on the same page as you DR.?


Thankyou

[H. Hunter Handsfield, M.D.]

I understood this and it doesn't change my opinion or advice.  The base of the penis is almost  always exposed to a partner's genital secretions during vaginal sex.  That's why condoms aren't 100% protective for some STDs, especially those passed by skin-to-skin contact.  But it's not a risk for HIV (and it's low risk for the others as well).  

Don't confuse your guilt over a sexual choice you regret with disease risk.  Deal with the first as you need to, and do your best to stop worrying about the second.

That should close this thread.  I won't have any further comments or advice.

[alilworried721]

Hey doctor i was just following up. A few weeks after my post i went to the emergecy room about the rashes and doctor said it was Tinea Versicolor. I didnt really trust what he said because he did diagnosed me very quick and he had a I DONT CARE attitude. so i went to see my primary doctor for a second oppinon and he said it was Rosea Pityriasis. He really took his time with me and talked to me and made me feel comfortable. Like you said doctor they had to test me for syphilis to make sure it wasnt that. The syphillis (syphilis) test came back negative. So just for the heck of it i had him test me for everything cause i never had a full STD test. All test came back negative for HIV,1 & 2 Hep A,B,C, Syphilis, Gonnerhea HSV 1. I did test positive for HSV 2. He said there is no way of telling when i caught it i, could of had it for years. He also said there is no way of tracking down who gave it to me especially since its really common and alot of people dont  even know they have it. At least to my knowledge i never seen a breakout on my self. He said it was genital HSV-2. I do have 1 and only 1 question i PROMISE. This has to do with after the non exposure above. Since i do have HSV-2 is a Hand Job still consider safe sex with no condom and vaginal fluid on hands or is that something i need to stay away from and use protection ?

[H. Hunter Handsfield, M.D.]

Your test results confirm all I said above.  HSV-2 is not transmitted by hand-genital contact.  There may be a good chance you don't have HSV-2, despite the test result.  If you need more information than that about your HSV-2 test result, you'll have to post a question in a new thread.  Before you spend a posting fee, I suggest you scan the forum threads, or use the search function, to find other replies to similar questions.  There have been many of them (maybe hundreds) over the years.

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