HIV - Prevention Expert Forum
Pre-seminal fluid "risk", and oral symptoms
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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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Pre-seminal fluid "risk", and oral symptoms

Dr. HHH, thank you so much for providing this forum.  It has been an invaluable source of information and reassurance.  

I am 19, and a heterosexual male.  My exposure, however, took place with anther male on 4/14/2007.  I engaged in insertive and receptive oral sex, but there was no ejaculation.  However, there was pre-seminal fluid.  My partner has assured me that he is HIV negative, but  I was overtaken with guilt and anxiety from the event and I have been very worried ever since.  It did greatly help to find out that my 8-week tests were negative, though.  

I was feeling great, but two weeks ago I developed inflamed taste buds and a tingling tongue, along with canker sores.  I have had canker sores before, so it is my tongue concerns me.  In addition to my tongue, I have developed what I think are sores in my throat.  As far as my overall feeling of well-being is concerned, I do not feel sick at all .  Currently, the canker sores are gone but the inflamed taste buds and sore throat remain.  The tongue tingling comes and goes, but is not as severe as its initial onset.

Here are my questions:

1) What is your opinion on the risk of HIV transmission through pre-seminal fluid?  I have read many different opinions on the matter ranging from "zero risk" to "regular oral sex risk" (which I know is very low).

2) The tongue and throat symptoms are most likely a common viral infection, right?  I read from another source (I don't trust its credibility, though) that HIV can open an outlet for these infections, but that is only in patients who have had the virus for extended periods of time, correct, not just 4 months?

3) Medically, would you even recommend another test if it weren't for my anxiety about the situation?

Thank you so much for providing this forum, it truly is an outstanding resource!  Enjoy the rest of your summer!
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The combination of the low risk nature of the exposure (oral sex), your partner's assertion he doesn't have HIV, and the negative test result at 8 weeks prove conclusively that your symptoms cannot be due to HIV.  And they don't sound like HIV.

1) There are no data on the risk of HIV transmission via pre-ejaculate fluid, whether orally or by any other route.  But the risk of performing oral sex on another man, even with ejaculation, is estimated at 1 chance 10,000. (Divide that by 365 to find the number of years it might take to get infected if you gave a BJ to an infected guy every day.)

2) Any number of viruses, allergies, changes in diet, or other things could cause such symptoms.  I cannot guess the cause in your case.  You are right not to trust the website you quote:  HIV does not significantly increase the risk of garden-variety cold viruses and the like.

3) Medically, you really didn't need testing at all and you certainly don't need any more testing.  As you say, anxiety relief is the only reason to consider it, and that part of the equation is up to you.

Best wishes--  HHH, MD
Thank you very much for your input, doctor.  I actually saw my GP today and she diagnosed my symptoms as Hand-Foot-and-Mouth Virus.  So, I am feeling much, much better.  She also assured me that it was just a bad coincidence with my situation.  Thanks again for your input and advice; I greatly appreciate.  Thanks again!
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H. Hunter Handsfield, M.D.Blank
University of Washington
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University of Alabama at Birmingham
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