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Possible HIV infection from fluids in anus
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Possible HIV infection from fluids in anus

Hello Doctor,

I am a male who met with a male on Dec 30.  I ejaculated on his face manually.  As I came he stick his tongue out and touched the urethra for about 1-3 seconds.  As I went to the bathroom to wash off, he came in and started running his fingers down the crack of my anus and at one point penetrated my anus wiht his finger (I believe he had his cum on his fingers when he inserted them in my anus).

I'm worried for many reason:
1. I have HSV2 and am not sure if I had a break out or not on my penis. WOuld his tongue touching my urethra be a problem?

2. He was touching his own anus and penis and then moved his fingers into my anus with cum.

3. 7 days after our meeting, I have had a sore throat, sore armpits and sore ears (still ongoing as of today, day 23).

4. Worst off, I have had a very large red rash since day 12 on my anus that itches, is sore and won't go away.  I've been to the doctor who prescribed some cream 10 days ago and it has done nothing to alleviate the rash.

I've been to the doctor on day 18 and had all STDS looked at.  All came back negative except for HSV2.  I'm scared that this individual has HIV as they will not tell me their status after I confronted them about the rash on my anus (which I've never had in my life and seems too much of a coincidence to start right after our meeting).

Any info is more than appreciated. I am a pretty healthy person and these ailments that have come post my meeting with this other man seem too much of a coincidence to not be afraid for HIV.  Please help!
239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

Like many people who come to the forum, you seem to have an inflated view of the potential for sexual transmission of HIV.  Here is the simple version:  if a bare penis (no condom) is not inserted INSIDE another person's vagina, rectum or (maybe) mouth, there is no risk of transmission.  The sorts of contact you describe here carry no measurable risk of HIV transmission, even when one partner is known to be infected.

1) HSV-2 raises the risk of HIV if exposed, but the sort of contact you describe doesn't count as an exposure.

2) Also no risk.

3) These symptoms are not suggestive of a new HIV infection, which would not cause armpit pain; and in any case, HIV cannot cause symptoms sooner than about 10 days after catching it.

4) HIV is not a cause of an anal area irritative rash.  The skin rash of primary HIV infection is painless and occurs primarily on the trunk, arms, and legs; it looks like measles. Your rash sounds like a yeast infection or other localized skin infection.

My advice is that you return to the doctor you have seen, mainly to have the anal rash reevaluated.  I'm sure it will be easily treated once the exact cause is known.  I'm sure it isn't HIV or any other STD.

Best regards--  HHH, MD
9 Comments
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Avatar_m_tn
Does this exposure need any hiv testing? I know you say this is low risk, but I should get tested, no? Also the touch touched my urethra when I was ejaculating. Wouldn't that pose a risk? Especially with hsv2?
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239123_tn?1267651214
From a risk standpoint or your symptoms, no testing is necessary for HIV. Of course you are free to do it if you feel you need the additional reassurance of a negative test result.

It would be a waste of money and time to be tested for HSV-2.  Since you already have it, you are immune to a new infection with it.  Therefore, HSV-2 is not a possible cause of your anal rash.  And even if you are susceptible, the chance of HSV transmission from the exposure you have described is almost as low as for HIV.
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Avatar_m_tn
Hi doctor, one last question. I've actually never been tested for hsv2. My wife has it and we have only had unprotected sex for 10 years. I've noticed itchy and pinching pains on my penis in past but never got tested. I just assumes I had hsv2.

If by some chance I currently do not have hsv2, is this rash a sign of herpes? Also, I forgot to mention a week after I met the guy I had unprotected sex with my wife. She had a break out 5 days after that (she rarely if ever has break outs).

Long story short: if I do not have herpes, is this rash a sign of herpes? Is this making any chance that I would get hiv?
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239123_tn?1267651214
Your anal rash doesn't sound at all like herpes.

On the basis of your sexual exposure, I still don't recommend HSV testing.  However, I do recommend such testing in people who are the regular sex partners of persons with HSV-2.  Given your wife's infection, it would be reasonable for you to be tested someday.  However, the penile symptoms you describe don't sound like herpes.

If you decide to have an HSV blood test, do it right away.  It's too soon to be positive from a new infection, so if positive for HSV-2, it will be attributable to infection from your wife.  But if you want a couple more weeks, and the result is positive, you won't know when you were infected. Be sure you have only an IgG test; the IgM HSV tests are unreliable and could give confusing results; see the thread linked below.

http://www.medhelp.org/posts/show/248394
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Avatar_m_tn
So just to be 100% clear, you do not think I need to get tested for hiv?
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239123_tn?1267651214
Oh come on.  What isn't "100% clear" from my comments above?  Do you really need to hear it a second time?  

Move on.  End of thread.
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Avatar_m_tn
I know you said end of thread...but this is urgent. My wife who I've had unprotected sex with has since grown a sizable blemish on her neck. It is not a pimple and when I google hiv rash it looks something like it. So far it is just 1 mark, but it has been there for 5 days now. I'm freaking out. She washes it and puts pimple cream on but nothing works.

she has never had anything like this before. Please help in my time of need! I will be forever grateful!!
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239123_tn?1267651214
Your wife's problem has nothing to do with HIV or with the sexual experience reported above.  She should see a doctor if it continues to bother her.

If you continue to post such anxiety driven comments that ignore the advice you have had, the entire thread will be deleted without further comment.
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