Oral Sex with Dry Mouth

Hi Dr.

About 4 weeks ago I performed oral sex on a male partner. I asked if he was HIV- and he said that yes he was (after a second of hesitation - which makes me nervous). Well, stupidly I had done cocaine earlier in the evening which really impaired my judgment. So I engaged in oral sex with him while I had a killer case of dry mouth (didn't work too well as you can imagine).  About 2.5 weeks ago I developed some small red spots on my torso that blanched when pressed. Some were flat and others raised. I've had spots like that before as I have acne prone skin. In addition to that I developed what looked like mosquito bites that didn't itch, two on my forearm and one on my abdomen a week later. I had no other symptoms. I know symptoms don't mean anything but still. My question is does this put me at a high risk of HIV infection? I was tested about 3 days after the spots appeared, which was negative. I know an HIV test at 2 weeks is pretty much useless. I'm really worried about this.

-Thank you for your help!

[Edward W Hook, MD]

I understand your concern.  The rash you describe is compatible with the rash of the ARS HOWEVER, please remember that there are no well documented cases of HIV transmission by oral sex, that you do not know that your partner had HIV, and that the ARS is typically not an isolated rash but is accompanied by flu-like symptoms which include fever, muscle aches, etc.  Thus is remains much, much more likely that your rash was due to something else (acne as you suggest, some other community acquired virus, soap or other chemical exposure, etc).  If it was ARS (which is most unlikely) now, almost two weeks after the appearance of the rash, your HIV test would be expected to be positive.  if you chose to get tested at this time and your test is negative as I suspect it will be, you can be confident that you did not get HIV from your exposure.  

The odds are VERY MUCH in your favor that you are not  the first person to get HIV from oral sex.  Hope this helps.  EWH

[Tullay]

I forgot to mention there was no ejaculate.

[Tullay]

Thank you so much, I'll get tested tomorrow. Just a bit of clarification, would dry mouth increase the theoretical risk of exposure. Also, would you recommend any test other than the standard ELISA. perhaps a duo just in case?

Thanks again

[Edward W Hook, MD]

Perhaps but in theory only,  I just also noted that you basically asked the same question of Dr. Handsfield yesterday.  You ave now heard the same answer from each of us.  No further questions please.  EWH